Abstract

GENTILE NANI, Sara et al. Upper urinary tract tumors. Arch. Esp. Urol. [online]. 2009, vol.62, n.5, pp.349-357. ISSN 0004-0614.

Objectives: To study the clinical, diagnostic, and therapeutic features of upper urinary tract tumors. Methods: We perform a retrospective study of upper urinary tract tumors treated in our Department at Clinica La Luz Madrid between 1995 and 2008. Results: We treated 42 tumors in 40 patients. Mean age was 64 years; there were 29 males and 11 females. Macroscopic hematuria was the most frequent clinical presentation, in 45% of the cases, and the imaging diagnostic test most frequently used was intravenous urogram (62,5%).There were more tumors on the right side (20 cases) than the left side (18 cases), 2 cases were bilateral. Distal ureter was the most frequent site. 27,5% of the patients presented associated bladder tumors. The most frequently used therapy was laser endoscopic resection. 5 patients required a second operation due to recurrence and 2 more a programmed second procedure due to incomplete resection; 7 cases presented postoperative complications. 70% of the tumors were superficial. 40% of the cases underwent local chemotherapy with weekly bladder instillations of Mitomycin C for 8 weeks. Recurrence rate was 20% and mortality 10%. Conclusions: Upper urinary tract tumors keep being a rare entity appearing in mid-advanced ages. Radical nephroureterectomy with excision of bladder cuff has been the treatment of choice for years, but in recent years endoscopic treatment is gaining more importance and is showing good results in selected cases.

Keywords : Upper urinary tract tumors; Endoscopic treatment; Radical nephroureterectomy; Laser.

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