Primary carcinoma of the ureter: a prognostic study.

Fourty-one patients with primary invasive carcinomas of the ureter were seen at Memorial Hospital from 1947 to 1972. Overall survuval patterns were similiar in 19 patients with and 22 patients without prior or concomitant urothelial cancers elsewhere in the urinary tract, with 5-year survival rates, as estimated by the product-limit methos, of41% for both groups. Prognosis was determined primarily by anatomical stage of ureteral cancer. In 11 Stage A (submucosal) patients, 7 Stage B (muscular), 12 Stage C (periureteric fat), and 9Stage D (extraureteral), the similarly estimated 5-year survival rates were 91%, 43%, 23%, and nil, respectively. None of Stage A cases had metastases for periods ranging from 5 to 11 years after surgery alone. Seventy-eight percent of patients with more advanced stages died within 3 years of treatment, withmetastases mainly in pelvic and para-aortic lymph nodes.