Risk factors for subsequent bladder cancer recurrence following radical surgery for upper urinary tract urothelial cancer

Purpose: The purpose of this study was to determine the clinical and pathological risk factors for subsequent bladder recurrence for the patients suffering with transitional cell carcinoma in the upper urinary tract (UUT-TCC) following radical surgery, and these factors should allow more accurate prediction of the disease outcome. Materials and Methods: Between 1995 and 2004, a total of 71 patients underwent total nephroureterectomy for UUT-TCC. Patients with concomitant or previous bladder tumor or a follow-up period of less than 1 year were excluded in this study. Univarariate and multivariate analysis by Cox's proportional hazards model was used to determine the independent risk factors for intravesical tumor recurrence. Results: Fifteen out of 71 patients (21.1%) experienced subsequent intravesical tumor recurrence during a mean follow-up period of 16.5 months (range: 3-28). On univariate analysis, tumor size, multiplicity, stage and grade were significantly correlated with subsequent intravesical tumor recurrence. On the multivariate analysis, tumor stage and multiplicity had a statistically significant impact on the risk of subsequent intravesical tumor recurrence. Conclusions: Tumor stage and multiplicity are important factors for subsequent intravesical tumor recurrence in the patients who suffer with UUT-TCC following surgery. Therefore, closer follow-up might necessary for patients with multiple foci and high stage UUT-TCC for the early detection of subsequent intravesical tumor recurrences.