Skip to main content
Top
Published in: International Urology and Nephrology 5/2019

01-05-2019 | Urothelial Cancer | Urology - Original Paper

Urothelial carcinoma of the upper urinary tract: preoperative pyuria is not correlated with bladder cancer recurrence and survival

Authors: Bogomir Milojevic, Zoran Dzamic, Nebojsa Bojanic, Otas Durutovic, Aleksandar Janicic, Boris Kajmakovic, Isidora Grozdic Milojevic, Uros Bumbasirevic, Nikola Grubor, Sandra Sipetic Grujicic

Published in: International Urology and Nephrology | Issue 5/2019

Login to get access

Abstract

Objective

To identify the impact of preoperative pyuria on the bladder cancer recurrence and survival of patients who were treated surgically for UTUC.

Patients and methods

Study included 319 consecutive patients who were treated with RNU for UTUC. Cox proportional hazard regression models were used to evaluate the association of preoperative pyuria with outcome.

Results

Eighty patients (25.1%) had pyuria. Preoperative pyuria was associated with sex (P = 0.01), tumor focality (P = 0.01), tumor size (P = 0.05), tumor stage (P = 0.01), lymph node metastasis (P = 0.01), lymphovascular invasion (P = 0.02), and chemotherapy (P = 0.04). A total of 102 patients recurred, with a median time to bladder recurrence of 24.2 months. Bladder cancer recurrence-free survival rates for these 319 patients at 1, 3, 5, 7, and 10 years were 84.6, 72.4, 69.0, 68.3, and 68.0%, respectively. Preoperative pyuria was not independently associated with bladder cancer recurrence (HR 1.15; p = 0.5). Preoperative pyuria was associated with OS (HR 1.57; p = 0.02) and CSS (HR 1.65; p = 0.02). However, preoperative pyuria was not independently associated with OS and CSS (HR 1.07; p = 0.79).

Conclusions

Preoperative pyuria is unable to predict outcomes in a single-centre series of consecutive patients who were treated with RNU.
Literature
1.
go back to reference Park S, Hong B, Kim CS, Ahn H (2004) The impact of tumor location on prognosis of transitional cell carcinoma of upper urinary tract. J Urol 171:621–625CrossRefPubMed Park S, Hong B, Kim CS, Ahn H (2004) The impact of tumor location on prognosis of transitional cell carcinoma of upper urinary tract. J Urol 171:621–625CrossRefPubMed
2.
go back to reference Milojevic B, Djokic M, Sipetic-Grujicic S, Milenkovic-Petronic D, Vuksanovic A, Dragicevic D et al (2011) Bladder cancer after managing upper urinary tract transitional cell carcinoma: risk factors and survival. Int Urol Nephrol 43(3):729–735CrossRefPubMed Milojevic B, Djokic M, Sipetic-Grujicic S, Milenkovic-Petronic D, Vuksanovic A, Dragicevic D et al (2011) Bladder cancer after managing upper urinary tract transitional cell carcinoma: risk factors and survival. Int Urol Nephrol 43(3):729–735CrossRefPubMed
3.
go back to reference Yamashita S, Ito A, Mitsuzuka K, Tochigi T, Namima T, Soma F et al (2016) Clinical implications of intravesical recurrence after radical nephroureterectomy for upper urinary tract urothelial carcinoma. Int J Urol 23(5):378–384CrossRefPubMed Yamashita S, Ito A, Mitsuzuka K, Tochigi T, Namima T, Soma F et al (2016) Clinical implications of intravesical recurrence after radical nephroureterectomy for upper urinary tract urothelial carcinoma. Int J Urol 23(5):378–384CrossRefPubMed
4.
go back to reference Hooker JB, Mold JW, Kumar S (2014) Sterile pyuria in patients admitted to the hospital with infections outside of the urinary tract. J Am Board Fam Med 27:97–103CrossRefPubMed Hooker JB, Mold JW, Kumar S (2014) Sterile pyuria in patients admitted to the hospital with infections outside of the urinary tract. J Am Board Fam Med 27:97–103CrossRefPubMed
5.
go back to reference Jablonska J, Leschner S, Westphal K, Lienenklaus S, Weiss S (2010) Neutrophils responsive to endogenous IFN-beta regulate tumor angiogenesis and growth in a mouse tumor model. J Clin Invest 120:1151–1164CrossRefPubMedPubMedCentral Jablonska J, Leschner S, Westphal K, Lienenklaus S, Weiss S (2010) Neutrophils responsive to endogenous IFN-beta regulate tumor angiogenesis and growth in a mouse tumor model. J Clin Invest 120:1151–1164CrossRefPubMedPubMedCentral
6.
go back to reference Azuma T, Nagase Y, Oshi M (2013) Pyuria predicts poor prognosis in patients with non-muscle-invasive bladder cancer. Clin Genitourin Cancer 11:331–336CrossRefPubMed Azuma T, Nagase Y, Oshi M (2013) Pyuria predicts poor prognosis in patients with non-muscle-invasive bladder cancer. Clin Genitourin Cancer 11:331–336CrossRefPubMed
7.
go back to reference Yoshida T, Kinoshita H, Shimada S, Sugi M, Matsuda T (2017) Preoperative pyuria is a poor prognostic factor in patients with urothelial carcinoma of the upper urinary tract after surgery. Clin Genitourin Cancer 15(4):e543–e550CrossRefPubMed Yoshida T, Kinoshita H, Shimada S, Sugi M, Matsuda T (2017) Preoperative pyuria is a poor prognostic factor in patients with urothelial carcinoma of the upper urinary tract after surgery. Clin Genitourin Cancer 15(4):e543–e550CrossRefPubMed
8.
go back to reference Satake N, Ohno Y, Nakashima J, Ohori M, Tachibana M (2015) Prognostic value of preoperative pyuria in patients with non-muscle-invasive bladder cancer. Int J Urol 22(7):645–649CrossRefPubMed Satake N, Ohno Y, Nakashima J, Ohori M, Tachibana M (2015) Prognostic value of preoperative pyuria in patients with non-muscle-invasive bladder cancer. Int J Urol 22(7):645–649CrossRefPubMed
9.
go back to reference Liang C, Wang J, Liu H, Huang L, Xu D, Qian S et al (2016) Preoperative pyuria predicts advanced pathologic tumor stage and worse survival in patients with urothelial carcinoma of the upper urinary tract treated by radical nephroureterectomy. Urol Oncol 34(9):418.e1–418.e7CrossRef Liang C, Wang J, Liu H, Huang L, Xu D, Qian S et al (2016) Preoperative pyuria predicts advanced pathologic tumor stage and worse survival in patients with urothelial carcinoma of the upper urinary tract treated by radical nephroureterectomy. Urol Oncol 34(9):418.e1–418.e7CrossRef
10.
go back to reference Fleming ID, Cooper JS, Henson DE (1997) Genitourinary site. In: Touhey R (ed) AJCC cancer staging manual, 5th edn. Lippincott-Raven, Philadelphia, pp 231–246 Fleming ID, Cooper JS, Henson DE (1997) Genitourinary site. In: Touhey R (ed) AJCC cancer staging manual, 5th edn. Lippincott-Raven, Philadelphia, pp 231–246
11.
go back to reference Epstein JI, Amin MB, Reuter VR, Mostofi FK (1998) The World Health Organization/International Society of Urological pathology consensus classification of urothelial (transitional cell) neoplasms of the urinary bladder. Bladder Consensus Conference Committee. Am J Surg Pathol 22:1435–1448CrossRefPubMed Epstein JI, Amin MB, Reuter VR, Mostofi FK (1998) The World Health Organization/International Society of Urological pathology consensus classification of urothelial (transitional cell) neoplasms of the urinary bladder. Bladder Consensus Conference Committee. Am J Surg Pathol 22:1435–1448CrossRefPubMed
12.
go back to reference Milojevic B, Dzamic Z, Kajmakovic B, Durutovic O, Bumbasirevic U, Sipetic Grujicic S (2015) Prognostic impact of preoperative anemia on urothelial and extraurothelial recurrence in patients with upper tract urothelial carcinoma. Clin Genitourin Cancer. 13(5):485–491CrossRefPubMed Milojevic B, Dzamic Z, Kajmakovic B, Durutovic O, Bumbasirevic U, Sipetic Grujicic S (2015) Prognostic impact of preoperative anemia on urothelial and extraurothelial recurrence in patients with upper tract urothelial carcinoma. Clin Genitourin Cancer. 13(5):485–491CrossRefPubMed
13.
go back to reference Milojevic B, Dzamic Z, Kajmakovic B, Milenkovic Petronic D, Sipetic Grujicic S (2015) Urothelial carcinoma: recurrence and risk factors. J BUON 20(2):391–398PubMed Milojevic B, Dzamic Z, Kajmakovic B, Milenkovic Petronic D, Sipetic Grujicic S (2015) Urothelial carcinoma: recurrence and risk factors. J BUON 20(2):391–398PubMed
14.
go back to reference Habuchi T, Takahashi R, Yamada H, Kakehi Y, Sugiyama T, Yoshida O (1993) Metachronous multifocal development of urothelial cancers by intraluminal seeding. Lancet 342:1087–1088CrossRefPubMed Habuchi T, Takahashi R, Yamada H, Kakehi Y, Sugiyama T, Yoshida O (1993) Metachronous multifocal development of urothelial cancers by intraluminal seeding. Lancet 342:1087–1088CrossRefPubMed
15.
16.
go back to reference Mantovani A, Allavena P, Sica A, Balkwill F (2008) Cancer-related inflammation. Nature 454(7203):436–444CrossRef Mantovani A, Allavena P, Sica A, Balkwill F (2008) Cancer-related inflammation. Nature 454(7203):436–444CrossRef
18.
go back to reference Green DA, Rink M, Xylinas E, Matin SF, Stenzl A, Roupret M et al (2013) Urothelial carcinoma of the bladder and the upper tract: disparate twins. J Urol 189:1214–1221CrossRefPubMed Green DA, Rink M, Xylinas E, Matin SF, Stenzl A, Roupret M et al (2013) Urothelial carcinoma of the bladder and the upper tract: disparate twins. J Urol 189:1214–1221CrossRefPubMed
19.
go back to reference Roupret M, Colin P (2013) Urothelial carcinomas of the upper urinary tract are now recognised as a true and distinct entity from bladder cancer and belong fully to the broad spectrum of onco-urologic neoplasms. World J Urol 31:1–3CrossRefPubMed Roupret M, Colin P (2013) Urothelial carcinomas of the upper urinary tract are now recognised as a true and distinct entity from bladder cancer and belong fully to the broad spectrum of onco-urologic neoplasms. World J Urol 31:1–3CrossRefPubMed
Metadata
Title
Urothelial carcinoma of the upper urinary tract: preoperative pyuria is not correlated with bladder cancer recurrence and survival
Authors
Bogomir Milojevic
Zoran Dzamic
Nebojsa Bojanic
Otas Durutovic
Aleksandar Janicic
Boris Kajmakovic
Isidora Grozdic Milojevic
Uros Bumbasirevic
Nikola Grubor
Sandra Sipetic Grujicic
Publication date
01-05-2019
Publisher
Springer Netherlands
Published in
International Urology and Nephrology / Issue 5/2019
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-019-02133-1

Other articles of this Issue 5/2019

International Urology and Nephrology 5/2019 Go to the issue