Carcinomas of the renal pelvis and ureter: a clinicopathological study of 63 cases with a review of literature

Objective The aim of this study was to summarize the clinicopathological characteristics of patients with renal pelvis and ureteral carcinomas, and analyze the recurrence in the remaining urinary tract and metastasis outside the urinary tract after surgical treatment. Methods The patients’ characteristics, tumor stage and grade, recurrence and metastasis distribution were summarized by tables, respectively. Spearman rank test, Log-rank test, Kaplan-Meier survival curve, and Cox proportional hazards regression model were used to make statistical analysis. Results A total of 63 patients with 30 men, 33 women, 30 renal pelvic tumors and 33 ureteral tumors was found. Seven had multifocal lesions. Fifty-four underwent surgical operation, which contained 49 cases of pathologically confirmed transitional cell carcinoma, 4 transitional cell carcinoma with squamous differentiation, and 1 squamous cell carcinoma. Tumor stage and grade had positive correlation. Among the 34 followed-up cases, 21 had no metastasis, 10 had metastasis, in which stage T3–4 groups accounted for 90%, and 5 developed tumor recurrences. The metastasis-free survivals had no significant difference between renal pelvic carcinoma and ureteral carcinoma, but had significant difference between high, middle and low stage groups, and between high and low grade groups. Conclusion The incidence rates of the renal pelvic carcinoma and ureteral carcinoma is similar and no gender difference. Multifocal lesions can be seen in any stage and grade, but this is not necessarily a symbol of poor prognosis. The bladder recurrences is often seen in the cases with initially multifocal lesions or lesions in the middle or lower portion of the ureter. The prognosis is good after resection of the recurrence lesion. The prognosis get worse with the increasing stages and grades. Stage is the main factor to influence the survival. Metastasis outside the urinary tract is often seen in patients with high stage tumors.