Treatment in 50 cases of transitional cell carcinoma in renal pelvis and ureter

A total of 50 cases of primary tumors in the renal pelvis and ureter were treated in Tokyo University Branch Hospital (20 cases in 1966-1982) and in Tranomon Hospital (30 cases in 1977-1987). They were composed of 42 men and 8 women (5.3:1) with a mean age of 61 years. 31 patients suffered from renal pelvic tumors, 15 ureteral tumors and 4 tumors in both sites. The tumors were located in the left side in 33 cases, right in 16, and both sides in 1.86% of patients showed gross hematuria. The findings on IVP were filling defect (42%) and nonvisualization (33%). Positive urine cytology was obtained in 12 of 25 cases (48%). Surgery was performed in 47 cases. The remaining 3 cases were with advanced diseases. The surgeries were total nephroureterectomy plus ipsilateral retroperitoneal lymph node dissection in 26 cases, total nephroureterectomy without node dissection in 7, total nephroureterectomy and total cystectomy in 3, nephrectomy in 9, partial nephrectomy in 1 and segmental excision of ureter with ureteroureterostomy in one. Histologically, all tumors were transitional cell carcinoma. Over-all survival rates (Kaplan-Meier's method) of the operated patients at 1, 3, 5 years were 84.2%, 73.1% and 69.4%, respectively. The stage and grade of the tumors affected the prognosis. N factor at lymph node dissection was the most determining factor of prognosis. 3 advanced cases who did not receive surgery for primary site were treated with 5FU in 2, and with CAP in 1.2 of them died of the disease within 1 year after diagnosis, one patient was lost in follow up.(ABSTRACT TRUNCATED AT 250 WORDS)