OBJECTIVETo define the clinicopathological risk factors of intravesical recurrence of primary transitional cell carcinoma of the ureter after surgical intervention.

METHODSPatients with primary carcinoma of the ureter treated between January 2000 and December 2010 were retrospectively analyzed. The intravesical recurrence-free survival rate was calculated using Kaplan-Meier method. Multivariate analysis was conducted with Cox's regression.

RESULTSA total of 104 patients were enrolled, who were followed up for a median of 46 months (13-89 months). Thirty-nine of the patients showed postoperative intravesical recurrence. Urine exfoliative cytology (P=0.000), number of tumors (P=0.006), tumor grade (P=0.039) and co-existence of bladder tumor (P=0.014) were found to independently influence the postoperative intravesical recurrence. Patients with more risk factors had poorer intravesical recurrence-free survival.

CONCLUSIONUrine exfoliative cytology, number of tumors, tumor grade and co-existence of bladder tumor are independent risk factors for postoperative intravesical recurrence of primary transitional cell carcinoma of the ureter. Close follow-up and rigorous treatment are essential for patients with high risk factors.

Adult ; Aged ; Carcinoma, Transitional Cell ; pathology ; surgery ; Causality ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Regression Analysis ; Retrospective Studies ; Risk Factors ; Ureteral Neoplasms ; pathology ; surgery ; Urinary Bladder Neoplasms ; pathology

Objective:To study the influence of environmental radiation of radiotherapy workplace on the stereotactic radiation therapy(SRT) plan absolute dose verification with plastic scintillator detector Exradin W1.Methods:The computed tomography (CT) image of the stereotactic dose verification phantom (SDVP) was scanned and imported into the treatment planning system. Three schemes, including 3 cm × 3 cm to 20 cm × 20 cm square gradient field irradiation, virtual planning target volume(PTV) non-coplanar arcs irradiation and 10 cases of volumetric modulated arc radiotherapy SRT (VMAT SRT) clinical plan verification, were measured with or without a home-made shield over the photodiode. Measurements were recorded to analyze the impact of environmental radiation on dose measurement under different conditions.Results:The noise effect of the photodiode increased with the the lager open field size, and decreased with the reduced distance between the photodiode and isocenter. The contribution of photodiode noise effect increase with the lager non-coplanar arc field size, with the largest up to 4.16%. As for the clinical SRT plan verification measurement, the relative difference between the SRT plan measurements and treatment planning system(TPS) before and after shielding were (1.39±1.05)% and (0.59±1.03)%, respectively ( t=-5.343, P < 0.05). and for W1 vs. A16 microchamber was (1.22±1.56)% and (0.42±1.42)%, respectively ( t=-5.414, P < 0.05). Conclusions:The measurements of Exradin W1 are in good agreement with the TPS result and the ionization chamber measurements, but its accuracy is easily affected by the environmental radiation of radiotherapy workplace. To measure non-coplanar radiation, the photodiode should be placed as far away as possible from the isocenter and be properly shielded, which can effectively improve the accuracy and stability of the measurement and provide a strong guarantee for clinical precision radiotherapy.