[Metachronous tumors of the upper urinary tract following primary superficial tumors of the bladder].

OBJECTIVE

To evaluate the long term incidence of upper urinary tract tumours in patients with surface tumours of the bladder.

MATERIAL AND

METHODS

Analysis of 78 patients with primary tumour of the bladder pTa-pTl diagnosed between 1978 and 1988. These patients were followed for up to 10 to 21 years (mean follow-up 13.4 years) and were treated with transurethral resection and a variety of endovesical cytostatic agents.

RESULTS

Of all 78 patients, 9 (11%) developed an upper urinary tract tumour over an average of 9 years (range 4-18); 2 in the first 5 years, 4 between 5 to 10 years, and 3 between 10 and 18 years. The likelihood of finding a tumour in the upper tract if all 20-year old patients were to be followed would be 25.6% (Kaplan-Meier's method). A high percentage of all upper urinary tract tumours are infiltrant, but the cause of death in 44% of these patients is progression of the tumour of the bladder.

CONCLUSIONS

The percentage of tumours of the upper urinary tract that become metachronic following a tumour of the bladder, increases with the duration of the follow-up. A high percentage of these cases are already in high stages when diagnosed. It would be convenient to monitor the upper urinary tract with the same periodicity than the bladder in order to establish early diagnoses. These patients show a high mortality rate, in most cases secondary to progression of the tumour of the bladder.