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Saito T, Matsumoto K, Tanaka N, Fukumoto K, Yasumizu Y, Takeda T, Morita S, Kosaka T, Mizuno R, Asanuma H, Hara S, Oya M. Prognostic impact of tumor ureteral invasion on recurrence after radical cystectomy. Int Urol Nephrol 2024; 56:129-135. [PMID: 37731158 DOI: 10.1007/s11255-023-03808-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 09/12/2023] [Indexed: 09/22/2023]
Abstract
PURPOSE Several preoperative factors have been suggested to be risk factors of disease recurrence after radical cystectomy. There is no study focusing on the impact on prognosis of bladder tumor ureteral invasion in preoperative imaging. METHODS The study population consisted of 136 patients, all of whom underwent radical cystectomy during the period between 2007-2019. We excluded patients with concurrent or a history of upper tract urothelial carcinoma and who underwent radical cystectomy for other cancers or nononcologic reasons. The starting point of this study was the timing of neoadjuvant chemotherapy or radical cystectomy and the endpoint was the timing of disease recurrence. To identify the factors influencing recurrence, univariate and multivariate analyses were performed using the Cox proportional hazard model. Recurrence-free survival curves were constructed using the Kaplan-Meier method. RESULTS Ureteral invasion was observed in 20 (14.7%) patients. Disease recurrence was observed in 11 (55.0%) of 20 ureteral invasion positive patients and 35 (30.2%) of 116 ureteral invasion negative patients, respectively. In the ureteral invasion positive group, clinical T and N stage were higher and hydronephrosis were more common than in the ureteral invasion negative group. According to the multivariate analysis, ureteral invasion (hazard ratio: 2.307, p = 0.016) and clinical N stage ≥ 1 (hazard ratio: 2.140, p = 0.028) were independent risk factors for postoperative recurrence. In the ureteral invasion positive group, more local recurrences were observed. CONCLUSION This study suggested that ureteral invasion in preoperative imaging is a significant risk factor for postoperative recurrence.
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Affiliation(s)
- Takafumi Saito
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Kazuhiro Matsumoto
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
| | - Nobuyuki Tanaka
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Keishiro Fukumoto
- Department of Urology, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-Ku, Kawasaki, Kanagawa, 210-0013, Japan
| | - Yota Yasumizu
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Toshikazu Takeda
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Shinya Morita
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Takeo Kosaka
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Ryuichi Mizuno
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Hiroshi Asanuma
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Satoshi Hara
- Department of Urology, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-Ku, Kawasaki, Kanagawa, 210-0013, Japan
| | - Mototsugu Oya
- Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
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Ono H, Hori K, Tashima L, Tsuruta T, Nakatsuka SI, Ito K. A case of retroperitoneal desmoid-type fibromatosis that involved the unilateral ureter after gynaecologic surgery. Int J Surg Case Rep 2018; 47:30-33. [PMID: 29705676 PMCID: PMC5994688 DOI: 10.1016/j.ijscr.2018.03.039] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 03/21/2018] [Accepted: 03/27/2018] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Desmoid-type fibromatosis represents a rare, benign, soft tissue tumour that is locally invasive with high recurrence potential. PRESENTATION OF CASE We encountered a case of retroperitoneal desmoid-type fibromatosis in a 45-year-old woman who presented with chief complaints of stomach ache and vomiting. She underwent total abdominal hysterectomy and left salpingo-oophorectomy due to uterine myoma and a paroophoritic cyst at 42 years of age. Abdominal computed tomography showed a 5-cm left retroperitoneal tumour and severe hydronephrosis of the left kidney. Multiple imaging studies failed to provide a definitive diagnosis. Therefore, we performed tumour resection, right salpingo-oophorectomy, ureterectomy, and ureterocystostomy. The tumour surrounded the left ureter and adhered to the left internal/external iliac artery, rectum, bladder, and the edge of the vagina. Histopathologic examination yielded a diagnosis of retroperitoneal desmoid-type fibromatosis. One month after the operation, transvaginal sonography showed a 2-cm mass in the pelvis. We suspected tumour recurrence and commenced pharmacotherapy with tranilast (300mg/day, three times per day). Four months after the operation, the mass disappeared. DISCUSSION There are minimal reports of postoperative intra-abdominal desmoid-type fibromatosis and preoperative diagnosis is difficult. To the best of our knowledge, there are no reported cases of desmoid-type fibromatosis that involved the ureter with severe hydronephrosis following a gynaecologic operation. CONCLUSION We experienced a case of retroperitoneal desmoid-type fibromatosis that involved a unilateral ureter after gynaecologic surgery.
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Affiliation(s)
- Hitomi Ono
- Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Japan.
| | - Kensuke Hori
- Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Japan
| | - Lena Tashima
- Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Japan
| | - Tomohiko Tsuruta
- Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Japan
| | - Shin-Ichi Nakatsuka
- Department of Pathology, Kansai Rosai Hospital, Japan; Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Japan
| | - Kimihiko Ito
- Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Japan
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