Carcinoma of the ureter: natural history, management and 5-year survival.

We reviewed retrospectively 53 new cases of primary ureteral carcinoma. Each patient was staged pathologically and survival by operative procedure was compared. Depth of tumor invasion is the most accurate indicator of over-all outcome. Patients with stage A tumors had an 80 per cent 5-year survival rate, compared to only 33.3 per cent of the patients with stage C lesions. Patients also were divided into 2 groups: group 1 patients had a ureteral lesion only, and group 2 patients had a ureteral tumor and a second primary urothelial lesion. No difference was found in 5-year survival rates for patients in groups 1 (48.3 per cent) and 2 (47.7 per cent). Since prognosis for patients with low stage tumors was not enhanced by an aggressive operation a more conservative approach is indicated.