期刊
UROLOGIA INTERNATIONALIS
卷 105, 期 7-8, 页码 619-623出版社
KARGER
DOI: 10.1159/000512978
关键词
Upper urinary tract urothelial carcinoma; Upper urinary tract cytology; Atypical; Class III; Repeated RP; Ureteroscopy; Ureterorenoscopy
Management of patients with atypical urinary cytology (class III) of the upper urinary tract is complicated due to the risk of developing upper urinary tract urothelial carcinoma (UTUC). Initial CT findings of tumor-like lesions and wall thickening can help predict the presence of UTUC. Repeated RP, especially in patients with initial CT findings of tumor-like lesions, is recommended for optimal management of these patients.
Introduction: Management of patients with atypical urinary cytology (class III) of the upper urinary tract is often complicated because some patients develop upper urinary tract urothelial carcinoma (UTUC). Here, we aimed to help define the optimal management of these patients. Methods: We investigated 31 patients who underwent retrograde ureteropyelography (RP) and were diagnosed with atypical findings of upper urinary tract cytology. Results: UTUC was revealed in 17 of 31 patients during the follow-up period of 1 year or longer. Tumor-like lesions and wall thickening in the upper urinary tract on initial computed tomography (CT) were significant predictors of UTUC (p = 0.0002 and p = 0.012, respectively). All 11 patients with tumor-like lesions and 3 of 8 patients with wall thickening on initial CT underwent nephroureterectomy, and UTUC was confirmed histologically. Moreover, 3 of 12 patients with hydronephrosis only or with normal findings later went on to develop UTUC. Repeated RP performed within 6 months from the initial RP was able to distinguish patients with UTUC from those without, even in individuals with normal CT findings. Discussion/Conclusion: Repeated RP based on initial CT findings is recommended in patients with atypical urinary cytology of the upper urinary tract. Nephroureterectomy without repeated RP may be warranted in patients with tumor-like lesions on initial CT findings.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据