High-Grade Hydronephrosis Predicts Poor Outcomes After Radical Cystectomy in Patients with Bladder Cancer.
10.3346/jkms.2010.25.3.369
- Author:
Dong Suk KIM
1
;
Kang Su CHO
;
Young Hoon LEE
;
Nam Hoon CHO
;
Young Taek OH
;
Sung Joon HONG
Author Information
1. Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea. sjhong346@yuhs.ac
- Publication Type:Original Article
- Keywords:
Hydronephrosis;
Prognosis;
Urinary Bladder Neoplasms;
Cystectomy
- MeSH:
Adult;
Aged;
Carcinoma, Transitional Cell/diagnosis/*mortality/pathology/*surgery;
*Cystectomy;
Female;
Humans;
Hydronephrosis/classification/*pathology;
Male;
Middle Aged;
Multivariate Analysis;
Prognosis;
Retrospective Studies;
Survival Rate;
Treatment Outcome;
Urinary Bladder Neoplasms/diagnosis/*mortality/pathology/*surgery
- From:Journal of Korean Medical Science
2010;25(3):369-373
- CountryRepublic of Korea
- Language:English
-
Abstract:
We examined whether the presence and severity of preoperative hydronephrosis have prognostic significance in patients who underwent radical cystectomy for transitional cell carcinoma of the bladder. The medical records of 457 patients who underwent radical cystectomy for bladder cancer between 1986 and 2005 were retrospectively reviewed. Following the Society for Fetal Urology grading system, patients were divided into low-, and high-grade hydronephrosis groups. Clinicopathologic factors associated with preoperative hydronephrosis and survival were evaluated. Of a total of 406 patients, unilateral hydronephrosis was found in 74 (18.2%), bilateral hydronephrosis in 11 (2.7%), and no hydronephoris in 321 (79.1%). Low-grade hydronephrosis was found in 57 (12.2%) patients and high-grade hydronephrosis in 28 (6%). Preoperative hydronephrosis was related to higher pT stage and lymph node invasion. In univariate analysis, the presence of hydronephrosis, hydronephrosis grade, age, pT and pN stage, tumor grade, surgical margin, number of retrieved nodes, carcinoma in situ, and lymphovascular invasion were significant prognostic factors for cancer-specific survival. In multivariate analysis, bilateral hydronephrosis and high-grade hydronephrosis remained significant predictors for decreased survival. The presence of preoperative hydronephrosis, and high-grade hydronephrosis are significant prognostic factors in patients with bladder cancer after radical cystectomy.
