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Sasaki, Katsumi Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Wada, Koichiro Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Araki, Motoo Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Kobayashi, Yasuyuki Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Sugimoto, Morito Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Ebara, Shin Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Watanabe, Toyohiko Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Nasu, Yasutomo Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Abstract
 We elucidate the fate of cases clinically suspected of carcinoma in situ (Cis) of the upper tract with serial ureteroscopy. Of 143 patients who underwent ureteroscopy for suspected upper tract urothelial carcinoma (UTUC) between January 2008 and February 2016, 12 cases with consistently positive urine cytology and poorly detectable upper-tract malignancies by imaging were reviewed. In these 12 patients, 19 ureteroscopy procedures (25 renal units) were performed. Vesical random biopsy was performed before the 1st ureteroscopy to exclude malignancy of the bladder in all 12 cases. Median follow-up was 42 (13-67) months. Positive biopsy results at the 1st ureteroscopy were obtained in 3 (25%) patients and all were diagnosed wth Cis of the upper tract. Two (17%) of 9 patients who were negative or inconclusive at the 1st ureteroscopy were finally diagnosed as UTUC, but plural ureteroscopy procedures were needed for the diagnoses in both. Carcinoma of the bladder appeared in 5 (42%) patients during follow-up, despite the earlier ruling out of vesical malignancy. Four (33%) of those 5 patients never developed upper-tract urothelial carcinoma during follow-up. Caution is required before undertaking radical surgery for cases clinically suspected of Cis of the upper tract. In our experience, only 42% of such patients developed UTUC; another 33% eventually developed carcinoma of the bladder without UTUC.
Keywords
carcinoma in situ
carcinoma of the bladder
upper tract urothelial carcinoma
ureteroscopy
urine cytology
Amo Type
Original Article
Published Date
2017-06
Publication Title
Acta Medica Okayama
Volume
volume71
Issue
issue3
Publisher
Okayama University Medical School
Start Page
227
End Page
232
ISSN
0386-300X
NCID
AA00508441
Content Type
Journal Article
language
英語
Copyright Holders
CopyrightⒸ 2017 by Okayama University Medical School
File Version
publisher
Refereed
True
PubMed ID