Original Articles Clinical Investigations
Preoperative prediction of malignant involvement of resected ureters in patients undergoing radical cystectomy for bladder cancer
Article first published online: 29 OCT 2012
© 2012 The Japanese Urological Association
International Journal of Urology
Volume 20, Issue 5, pages 501–506, May 2013
How to Cite
Gondo, T., Nakashima, J., Ohno, Y., Hashimoto, T., Takizawa, I., Sakamoto, N., Horiguchi, Y., Aoyagi, T., Ohori, M. and Tachibana, M. (2013), Preoperative prediction of malignant involvement of resected ureters in patients undergoing radical cystectomy for bladder cancer. International Journal of Urology, 20: 501–506. doi: 10.1111/j.1442-2042.2012.03203.x
- Issue published online: 5 MAY 2013
- Article first published online: 29 OCT 2012
- Manuscript Accepted: 23 SEP 2012
- Manuscript Received: 17 APR 2012
- bladder cancer;
- preoperative prediction;
- radical cystectomy;
- ureteral involvement
To investigate preoperative predictors of ureteral involvement of bladder malignancy and to develop a novel preoperative model for the prediction of ureteral involvement in bladder cancer patients undergoing radical cystectomy.
This study included 197 consecutive bladder cancer patients treated with radical cystectomy. The correlations of preoperative factors with ureteral involvement were analyzed by univariate analysis with Pearson's χ2-test and multivariate logistic regression analysis with a stepwise selection procedure.
Positive ureteral involvement was observed in 38 (19.3%) patients. Tumor location (involvement of the vesical trigone), clinical T stage (≥ cT3) and the number of tumors (≥3), but not sex, tumor grade and histological features determined by transurethral resection of bladder tumor, tumor size, shape of tumor, concomitant presence of carcinoma in situ, preoperative intravesical therapy, number of transurethral resection of bladder tumor procedures or the presence of hydronephrosis were significantly associated with ureteral involvement in the univariate analysis. Multivariate logistic regression analysis confirmed that the aforementioned three significant factors identified in the univariate analysis were significant independent predictors of ureteral involvement. The probability of ureteral involvement estimated by a combination of these three parameters was well correlated with the real incidence (R = 0.904, P = 0.0021).
Tumor location (involvement of vesical trigone), clinical T stage (≥cT3) and the number of tumors (≥3) are significant independent preoperative predictors of ureteral involvement of malignancy in bladder cancer patients undergoing radical cystectomy. Our predictive model might be useful for preoperative prediction of ureteral tumor involvement.