The Effect of Tumor Localization and Clinicopathological Factors on Intravesical Recurrence and Survival in Primary Upper Urinary Tract Urothelial Tumors

Objective: We aimed to investigate the factors affecting intravesical recurrence and survival in patients undergoing radical nephroureterectomy and bladder cuff excision due to primary upper urinary system urothelial tumor (UUST) in our clinic. Materials and Methods: The data of 52 patients who were operated for primary UUST between 2008 and 2018 were retrospectively evaluated. All patients underwent preoperative computed tomography and magnetic resonance urography. Tumor localizations were grouped according to the ureteropelvic compound. During the follow-up period after radical surgery, the patients underwent physical examination, routine blood tests and radiological evaluation. The patients were followed up quarterly in the first two years, every six months for the next two years and then yearly with cystoscopy. Results: Thirteen female and 39 male patients with an average age of 60.5[+ or -]10.35 years were included in the study. Mean follow-up time was 66.8[+ or -]38.2 months. Thirty (58%) patients had renal tumors, 13 (25%) patients had ureteral tumors and 9 (17%) patients had multifocal tumors. Intravesical recurrence was detected in 9 (69%) patients with ureteral tumor (p=0.047). Ten-year overall survival of patients with ureteral tumors was 50% (35.4% side effect) (Log rank test=0.012). Recurrent-free survival was significantly worse in ureteral tumors (Hazard ratio:3, p=0.04). Conclusion: The ureteral tumor group was significantly worse in terms of postoperative intravesical recurrence and overall survival and recurrence-free survival. Keywords: Urothelial carcinoma, intravesical recurrence, cancer, ureters