关键词: 输尿管癌, 保留肾脏, 预后

Abstract: Objective To evaluate the clinical treatment and prognosis of the primary transitional cell carcinoma of ureter.Methods Retrospective review of 19 cases who underwent kidney-sparing surgery for treatment of the primary transitional cell carcinoma of ureter was carried out. There were 10 males and 9 females with the mean age of 65.6 years. 14 cases had gross hematuria and 2 cases had flank pain and in 3 cases renal hydronephrosis was found incidentally by B-ultrasound. Results All cases were treated with kidney-sparing surgery. In 15 cases ureteral segmental resection was performed, in 4 of these cases terminoterminal anastomosis and in 11 cases ureterocystostomy with bladder cuff excision were performed. In 4 cases tumor were resected by ureteroscopy. Postoperative pathological findings confirmed the diagnosis of transitional cell carcinoma. Pathological staging showed T_a (1 cases), T₁ (5 cases), T₂ (9 cases), T₃ (4 cases) and grading showed G₁ (5 cases);G₂ (8 cases); G₂-G₃ (3 cases);G₃ (3 cases). Seventeen cases (89.5%) were followed up for 3~132 months. The overall 5-year survival rate was 58.8%. Bladder recurrences occurred in 29.4% of patients within 6~24 post-operation months and 29.4% patient showed ipsilateral upper urinary tract transitional cell carcinoma recurrences within 12~72 post-operation months. Three cases died of non-tumor illness within 12~36 months postoperatively. Conclusion The primary transitional cell carcinoma of ureter may be uncommon and has poor prognosis. Kidney-sparing surgery is a feasible treatment option in patients with lower stage and grade. The long-term follow up should be meticulous, because the recurrence rate is high.

Key words: ureter carcinoma, kidney-sparing surgery, prognosis