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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Urology 1/2015

Diagnostic outcome of ureteroscopy in urothelial carcinoma of the upper urinary tract: Incidence of later cancer detection and its risk factors after the first examination

Zeitschrift:
BMC Urology > Ausgabe 1/2015
Autoren:
Norihiro Murahashi, Takashige Abe, Nobuo Shinohara, Sachiyo Murai, Toru Harabayashi, Ataru Sazawa, Satoru Maruyama, Kunihiko Tsuchiya, Naoto Miyajima, Kanako Hatanaka, Katsuya Nonomura
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

NM and TA drafted the manuscript. SM, KT, and NM collected the follow-up data. TA and SM conducted statistical analysis. TH and AS contributed to the study design. NS and KN revised this manuscript. All authors read and approved the final manuscript.

Abstract

Background

To determine the incidence of later cancer detection and its risk factors after the first diagnostic ureteroscopy.

Methods

One hundred and sixty-six patients undergoing diagnostic ureteroscopy based on the suspicion of urothelial carcinoma of the upper urinary tract (UC of the UUT) between 1995 and 2012 were included. We examined the diagnostic outcome of the initial ureteroscopy. Thereafter, we collected follow-up data on patients who had not been diagnosed with UC of the UUT at the first examination, and evaluated the incidence of later cancer detection and its risk factors using Cox hazard models.

Results

Of the 166 patients, 76 (45.8 %) were diagnosed with UC of the UUT at the first diagnostic ureteroscopy. The remaining 90 (54.2 %) were diagnosed with other malignancies (n = 22), non-malignant disorders (n = 18), or without disorders (n = 50). Of these 90 patients, follow-up data were available in 65 patients (median: 41 months, range: 3–170). During the follow-up, carcinoma was detected in 6 patients (6/65, 9.2 %) at a median of 43.5 months (range: 10–59). Episodes of gross hematuria (p = 0.0048) and abnormal cytological findings (p = 0.0335) during the follow-up and a male sex (p = 0.0316) were adverse risk factors.

Conclusion

Later cancer detection of UC of the UUT was not uncommon after the first examination. The risk analysis revealed the aforementioned characteristics.
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