Prognostic impact of parenchymal invasion pattern and adjuvant chemotherapy in pT3 transitional cell carcinoma of the renal pelvis

Purpose: This study was designed to assess the prognosis of pT3 transitional cell carcinoma of the renal pelvis (renal pelvic tumor) according to the parenchymal invasion pattern and adjuvant chemotherapy. Materials and Methods: A total of 48 (34 males and 14 females) patients were surgically treated for a renal pelvic tumor. Of these 48 patients, the 27 pT3 renal pelvic tumor patients who had over one year follow-up period were enrolled. The patients were divided into two groups according to the invasion pattern (Group 1: renal parenchymal invasion, Group 2: peripelvic fat invasion). Among these 27 patients, 15 patients received adjuvant chemotherapy following surgery, whereas the other 12 patients did not. The prognostic factors, including age, gender, laterality, tumor grade, size, lympho-vascular invasion, lymph node involvement, the invasion pattern and adjuvant chemotherapy, were analyzed with respect to disease-free survival. Results: There were seventeen patients in Group 1 and 10 patients in Group 2. The mean duration of follow up was 39.4 months. Age, gender, laterality, tumor grade, size, lympho-vascular invasion, invasion pattern and adjuvant chemotherapy had no significant impact on disease-free survival on both the univariate and multivariate analyses. Only lymph node involvement (p=0.028, hazard ratio=20.98) was a prognostic predictor in this study. However, the incidence of renal parenchymal invasion was higher for the high grade tumors than for the low grade tumors. Conclusions: The renal parenchymal invasion pattern and adjuvant chemotherapy had no significant impact on disease-free survival on both univariate and multivariate analyses for the patients with p.T3 renal pelvic tumor. Further studies are necessary to clarify this result.