Indications for ureteropyeloscopy based on radiographic findings and urine cytology in detection of upper urinary tract carcinoma

Akira Takao, Takashi Saika, Shinya Uehara, Koichi Monden, Fernando Abarzua, Yasutomo Nasu, Hiromi Kumon

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective: To verify the indication of diagnostic ureteropyeloscopy based on clinical features for upper urinary tract urothelial cancer with over 100 patients and over a 10-year series. Methods: From January 1997 to December 2008, consecutive 129 units in 124 patients underwent ureteropyeloscopy to obtain a definitive diagnosis of upper urinary tract cancer or to rule out a malignancy. Patients were divided into four subgroups based on voided urine cytology and preoperative radiographic findings: group A (n = 8), positive urine cytology and positive radiographic findings; group B (n = 4), positive cytology and negative radiographic findings; group C (n = 55), negative cytology and positive radiographic findings and group D (n = 62), gross hematuria originating from the upper urinary tract with negative cytology and negative radiographic findings. Ureteropyeloscopic findings were compared with radiographic and cytological results. Adverse effects were also investigated. Results: In group A, all patients had confirmed cancer. In group B, one revealed small cancer and the remaining three confirmed carcinoma in situ by biopsy with ureteropyeloscopy. In groups C and D, 33 patients (60%) and four (6.5%) revealed cancer. Seventy-eight patients out of 80 (97.5%) in groups C and D were confirmed to have benign disease. No patient was found with malignancy during follow up after negative finding of ureteropyeloscopy. Conclusions: Ureteropyeloscopy can help in detecting upper urinary tract cancer or to rule out malignancy for patients with negative voiding cytology. However, ureteropyeloscopy is redundant for patients with positive radiographic findings and positive voiding cytology.

Original languageEnglish
Article numberhyq096
Pages (from-to)1087-1091
Number of pages5
JournalJapanese journal of clinical oncology
Volume40
Issue number11
DOIs
Publication statusPublished - Nov 2010

Keywords

  • Diagnosis
  • Indication
  • Upper urinary tract carcinoma
  • Ureteropyeloscopy
  • Urothelial carcinoma

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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