Sten Holmäng1, Sonny L Johansson. 1. Department of Urology, Sahlgrenska University Hospital, Göteborg, Sweden. sten.holmang@telia.com
Abstract
OBJECTIVE: To investigate the relationships between diagnostic and treatment delay and tumour stage and survival among patients with malignant tumours in the renal pelvis and ureter. MATERIAL AND METHODS: A clinical and histopathological review was performed on 943 patients with a primary malignant tumour in the renal pelvis and ureter. We selected 394 patients who had macrohaematuria as an initial symptom, had no previous history of bladder cancer, had undergone surgery and had adequate follow-up. We performed uni- and multivariate analyses of prognostic factors for disease-specific survival. RESULTS: The median number of days between the first occurrence of macrohaematuria and surgery was 83.5 days (range 4-1770 days). Patients with advanced tumours had the shortest median delay. Advanced tumour stage, a solid growth pattern and vascular invasion were of prognostic importance for disease-specific survival in the multivariate analysis, but diagnostic and treatment delay were not. CONCLUSIONS: Although the delay was unacceptably long it still had no impact on survival, probably because macroscopic haematuria is a late symptom, in particular in high-grade tumours. New screening methods for the early detection of cancer and new treatment modalities are needed to improve the poor prognosis in stage pT3-pT4 tumours.
OBJECTIVE: To investigate the relationships between diagnostic and treatment delay and tumour stage and survival among patients with malignant tumours in the renal pelvis and ureter. MATERIAL AND METHODS: A clinical and histopathological review was performed on 943 patients with a primary malignant tumour in the renal pelvis and ureter. We selected 394 patients who had macrohaematuria as an initial symptom, had no previous history of bladder cancer, had undergone surgery and had adequate follow-up. We performed uni- and multivariate analyses of prognostic factors for disease-specific survival. RESULTS: The median number of days between the first occurrence of macrohaematuria and surgery was 83.5 days (range 4-1770 days). Patients with advanced tumours had the shortest median delay. Advanced tumour stage, a solid growth pattern and vascular invasion were of prognostic importance for disease-specific survival in the multivariate analysis, but diagnostic and treatment delay were not. CONCLUSIONS: Although the delay was unacceptably long it still had no impact on survival, probably because macroscopic haematuria is a late symptom, in particular in high-grade tumours. New screening methods for the early detection of cancer and new treatment modalities are needed to improve the poor prognosis in stage pT3-pT4 tumours.
Authors: Antonieta Medina-Lara; Bogdan Grigore; Ruth Lewis; Jaime Peters; Sarah Price; Paolo Landa; Sophie Robinson; Richard Neal; William Hamilton; Anne E Spencer Journal: Health Technol Assess Date: 2020-11 Impact factor: 4.014
Authors: Laurent Nison; Morgan Rouprêt; Grégory Bozzini; Adil Ouzzane; François Audenet; Géraldine Pignot; Alain Ruffion; Jean-Nicolas Cornu; Sophie Hurel; Antoine Valeri; Mathieu Roumiguie; Thomas Polguer; Nicolas Hoarau; Olivier Mérigot de Treigny; Evanguelos Xylinas; Alexandre Matte; Stéphane Droupy; Pierre Olivier Fais; Aurélien Descazeaud; Pierre Colin Journal: World J Urol Date: 2012-10-16 Impact factor: 4.226
Authors: R D Neal; P Tharmanathan; B France; N U Din; S Cotton; J Fallon-Ferguson; W Hamilton; A Hendry; M Hendry; R Lewis; U Macleod; E D Mitchell; M Pickett; T Rai; K Shaw; N Stuart; M L Tørring; C Wilkinson; B Williams; N Williams; J Emery Journal: Br J Cancer Date: 2015-03-31 Impact factor: 7.640