Background & Objective: With the development of diagnostic techniques of imaging, and application of endoscope, early diagnosis and treatment of transitional cell carcinoma (TCC) of upper urinary tract have been improved to a great extent in recent years, but still caused debates. In this article, we discussed the diagnostic and therapeutic methods of TCC of upper urinary tract.
Methods: Clinical data of 123 patients with TCC of upper urinary tract treated in our hospital from Mar. 1996 to Dec. 2003 were retrospectively analyzed.
Results: Ratios of final diagnosis of renal pelvic cancer (RPC) by B ultrasound, intravenous pyelogram (IVP), and computed tomography (CT) were 82.1% (46/56), 37.1% (20/54), and 88.1% (37/42), respectively; those of ureter cancer were 11.8% (4/34), 3.2% (1/31), and 93.8% (15/16), respectively. Successful retrograde pyelography could locate both kinds of carcinomas accurately. Of 123 patients, 116 underwent radical surgery, and 7 given up for metastasis or poor heart and lung function; 107(87.0%) were followed-up with a mean of 3.5 years. Three-year survival rates of patients with superficial RPC (stage T1), and invasive RPC (stages T2-T4, or N1, N2) were 94.1%, and 73.6%; 5-year survival rates were 88.2%, and 43.3%. Three-year survival rates of patients with superficial ureter cancer, and invasive ureter cancer were 100%, and 68.8%; 5-year survival rates were 80.0%, and 40.6%. Bladder tumor occurred in 29 (23.6%) patients.
Conclusions: Combination of IVP and B ultrasound should be used as a routine examination for TCC of upper urinary tract. Retrograde pyelography may be used as an adjuvant examination when IVP showed negative results, CT may be used for further examination. Radical resection of kidney and ureter is the preferred treatment for this disease.
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