Upper urinary tract cancer: Location is correlated with prognosis

Objectives: Evaluate prognostic information of anatomical location in patients with upper tract transitional cell carcinoma (UTTCC). Methods: Retrospective analysis of 149 upper tract transitional cell carcinoma (UTTCC) patients from a single institute treated surgically between 1988 and 2003. Results: Transmural tumor growth (pT3 or pT4) was less common in distally located tumors (33%) compared to mid (44%), proximal ureter (75%) or pyelum tumors (41%). Tumor stage was the best predictor of disease specific survival. Distally located tumors had a significantly better survival than proximally located cancers (median survival 53 months versus 16 months for tumors in the proximal ureter). Bladder cancer was found in 73 (49%) patients. Invasive UTTCC were less likely to be associated bladder cancer (RR 0.66, 95%CI 0.43-0.98). In a multivariate analysis both tumor stage and location in the upper tract were predictive of disease specific survival after UTTCC diagnosis. Conclusion: Tumor location in the proximal upper tract predicts stage-independent poor prognosis in patients with UTTCC.