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  • Title: [Upper urothelium tumor in patients treated with radical cystectomy for transitional carcinoma of the bladder].
    Author: Herranz Amo F, Verdú Tartajo F, Díez Cordero JM, Bueno Chomón G, Leal Hernández F, Bielsa Carrillo A.
    Journal: Actas Urol Esp; 1999 Mar; 23(3):214-8. PubMed ID: 10363377.
    Abstract:
    OBJECTIVE: To evaluate the incidence and characteristics of tumours in the upper endothelium (TUE) that develop in patients with transitional carcinoma of the bladder treated with radical cystectomy. MATERIAL AND METHOD: Between 1986 and 1996, 160 evaluable patients who underwent cystectomy due to transitional cancer of the bladder were reviewed and found to be infiltrant in 96% cases. Follow-up either until death or to the date of the study, was carried out with intravenous urography (IVU) in the first 6 months with additional urographies at least every two years. RESULTS: Five (3.1%) patients showed progress of the upper endothelium tumour, which was multifocal in 3 patients and infiltrant also in 3. No association was seen in these patients with in situ carcinoma of the bladder, or urethral invasion by the primary tumour: only one patient had tumour involvement of end ureters. After three months from diagnosis, tumour-related mortality was 50%. Incidence of upper endothelium tumours in patients with infiltrant tumour of the bladder was lower (1.9%) than in patients with surface tumour of the bladder (16.6%). CONCLUSION: Based on data from our series, the incidence of TUE was 3.1% with a mean time interval between cystectomy and TUE diagnosis of 25.4 months. IVU was diagnostic only in 40% cases. No risk factors were identified in our patients, and mortality due to advanced stage of TUE at three months was 50%. The high percentage of patients with advanced TUE in our series warrants the addition of an annual IVU in the follow-up of these patients.
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