Severity of hydronephrosis correlates with tumour invasiveness and urinary bladder recurrence of ureteric cancer (Lynch Syndrome patients)

Abstract

Upper Urinary Tract

Objectives

• To explore the prognostic role of hydronephrosis grade in patients with pure ureteric cancer.

Patients and Methods

• The study included 162 patients with pure ureteric cancer who were treated between January 2005 and December 2010 at a single tertiary referral centre.
• The association between hydronephrosis grade with pathological findings and oncological outcomes was assessed using multivariate Cox regression analysis.

Results

• Hydronephrosis grade >2 was independently associated with non-organ-confined ureteric cancer (P = 0.003).
• Hydronephrosis grade <2 was highly prevalent in organ-confined disease.
• Hydronephrosis grade >2 and bladder cancer history independently predict bladder cancer recurrence (P = 0.021 and P = 0.002, respectively)
• Hydronephrosis of grade >2 was found to be associated with local and distant recurrence only in univariate analysis; non-organ-confined pathology independently predicted local and distant oncological failure (P ≤ 0.001 and P = 0.002, respectively).

Conclusions

• Hydronephrosis grade >2 is associated with non-organ-confined ureteric cancer and with bladder cancer recurrence.
• Non-organ-confined pathology is still the most important predictor for local and distant oncological failure.