Details

Autor(en) / Beteiligte

• Mazeman, Etienne

Titel

Tumours of the Upper Urinary Tract Calyces, Renal Pelvis and Ureter

Ist Teil von

• European urology, 1976, Vol.2 (3), p.120-128

Ort / Verlag

Basel, Switzerland

Erscheinungsjahr

1976

Quelle

MEDLINE

Beschreibungen/Notizen

• The author reviews 1,118 cases of tumour of the upper urinary tract, arising in the urothelium of the calyces, the renal pelvis and the ureter. This was presented at the 66th Congress of the French Urological Association. Tumours of the renal pelvis and calyces are more common (66 %) than those of the ureter (34 %). Men are more often affected than women (3.4 times). 27 % of the tumours are multiple. They are usually epithelial and papillary. Their etiology and pathogenesis remain debatable. Haematuria is the main presenting symptom. Filling defects and narrowing are the most suggestive signs on urography. 1,096 tumours were operated on. The operative mortality was 7.8 %. Early epithelial recurrences, immediately distal to the primary tumour, were observed in 31 % of cases. Lymph node and blood métastasés were less frequent (16 and 17 %, respectively). A study of the results shows that treatment depends on the position of the primary tumour. (1) When it is situated in the renal pelvis or a calyx, one-stage total nephro-ureterectomy is the best treatment. The frequency and severity of relapses make it strongly advisable not to leave even a short segment of the ureter. (2) When the tumour is situated in the ureter and is multiple, total nephro-ureterectomy is also necessary. (3) When it is ureteral and unique, conservative surgery, such as ureterectomy and re-implantation or segmental ureterectomy and ureterorrhaphy, is justified by the good results. Peri-ureteric tissue should be removed as routine in malignant tumours. Radiotherapy and chemotherapy are of limited value. Prolonged clinical, urographie and endoscopic follow-up is essential.