a comparative study of two treatment methods for bilateral upper urinary tract transitional cell carcinoma

Abstract

Objective 　To evaluate two treatment methods for bilateral upper urinary tract transitional cell carcinomas (TCCs). Methods 　Clinical data of 43 patients with bilateral upper urinary tract TCCs treated in our hospital from 1994 to 2006 were analyzed retrospectively. Of them, 13 patients underwent bilateral nephroureterectomy and the rest 30 patients received unilateral nephroureterectomy and contralateral organ-preserving surgery, including partial nephrectomy, partial pelvectomy, partial ureterectomy＋end-to-end ureteral anastomosis, distal ureterectomy＋reimplantation and endoscopic resection. The data were analyzed and compared between the two groups using SPSS software. Results 　There were no statistical differences between two groups in age, gender, incidence of hematuria, low back pain and abdominal pain, smoking, number of tumor, tumor stage, tumor grade, recurrence time, recurrence rate, survival time, survival rate, or taking aristolochic acid drugs (P>0.05). Significantly higher post-surgical costs and lower survival condition satisfaction score were found among the patients undergoing bilateral nephroureterectomy, showing a significant statistical difference between the two groups (P < 0.001). Conclusions 　For synchronous or metachronous bilateral upper urinary tract TCCs, bilateral nephroureterectomy results in similar clinical outcomes compared with that of unilateral nephroureterectomy + contralateral organ-preserving surgery, but the latter costs lower postoperative expenses and higher life quality, therefore it is worthy to be popularized.