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1. Takayama T, Nagata M, Unno T, Mugiya S, Hata M, Suzuki K, Fujita K: [A clinical study of patients undergoing curative surgery for renal pelvic and ureteral cancers]. Hinyokika Kiyo; 2000 Mar;46(3):155-9
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  • [Title] [A clinical study of patients undergoing curative surgery for renal pelvic and ureteral cancers].
  • We retrospectively studied 30 patients who underwent curative surgery for renal pelvic and/or ureteral cancer between August 1987 and August 1998.
  • Nine patients who received adjuvant chemotherapy are alive, but 3 patients have relapsed.
  • Chemotherapy did not have a significant effect on the cause-specific survival or disease-free survival.
  • [MeSH-major] Kidney Neoplasms / surgery. Ureteral Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Disease-Free Survival. Female. Humans. Kidney Pelvis. Male. Middle Aged. Neoplasm Recurrence, Local / epidemiology. Neoplasm Staging. Prognosis. Retrospective Studies. Risk Factors. Survival Rate

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  • (PMID = 10806570.001).
  • [ISSN] 0018-1994
  • [Journal-full-title] Hinyokika kiyo. Acta urologica Japonica
  • [ISO-abbreviation] Hinyokika Kiyo
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] JAPAN
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2. Matin SF, Margulis V, Kamat A, Wood CG, Grossman HB, Brown GA, Dinney CP, Millikan R, Siefker-Radtke AO: Incidence of downstaging and complete remission after neoadjuvant chemotherapy for high-risk upper tract transitional cell carcinoma. Cancer; 2010 Jul 1;116(13):3127-34
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  • [Title] Incidence of downstaging and complete remission after neoadjuvant chemotherapy for high-risk upper tract transitional cell carcinoma.
  • BACKGROUND: The authors evaluated the incidence of pathologic downstaging and complete remission (CR) in patients with high-grade ureteral and renal pelvic transitional cell carcinoma (TCC) (upper tract TCC) who received neoadjuvant chemotherapy followed by surgery.
  • METHODS: The study group comprised patients with biopsy-demonstrated, high-grade disease who received neoadjuvant chemotherapy followed by nephrouterectomy from 2004 to 2008, during which time patients uniformly were considered for neoadjuvant chemotherapy.
  • Multiple clinical and pathologic features were evaluated, and the primary endpoint was pathologic tumor classification.
  • RESULTS: One hundred seven patients in the control group underwent initial surgery, and 43 patients in the study group received neoadjuvant chemotherapy.
  • Baseline demographics were similar between the groups except for a higher rate of sessile tumor architecture in the study group (72.1% vs 49.5%; P = .018).
  • Fourteen percent of patients who received neoadjuvant chemotherapy had a pathologic CR.
  • CONCLUSIONS: Neoadjuvant chemotherapy was associated with a 14% CR rate and a significant rate of downstaging.
  • [MeSH-major] Carcinoma, Transitional Cell / drug therapy. Neoadjuvant Therapy
  • [MeSH-minor] Aged. Chemotherapy, Adjuvant. Combined Modality Therapy. Female. Humans. Lymphatic Metastasis. Male. Neoplasm Staging. Remission Induction. Retrospective Studies. Risk Factors

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  • (PMID = 20564621.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA091846-08
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
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3. Onishi T, Franco OE, Shibahara T, Arima K, Sugimura Y: Papillary adenocarcinoma of the renal pelvis and ureter producing carcinoembryonic antigen, carbohydrate antigen 19-9 and carbohydrate antigen 125. Int J Urol; 2005 Feb;12(2):214-6
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  • [Title] Papillary adenocarcinoma of the renal pelvis and ureter producing carcinoembryonic antigen, carbohydrate antigen 19-9 and carbohydrate antigen 125.
  • We report a case of advanced renal pelvis and ureter adenocarcinoma producing carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) and carbohydrate antigen 125 (CA125).
  • A 72-year-old woman was diagnosed with right renal pelvic and ureter tumor with para-aortic lymph node swelling.
  • Biopsy of the ureteral mass revealed papillary adenocarcinoma.
  • The patient was successfully treated with paclitaxel/carboplatin chemotherapy followed by surgery.
  • [MeSH-major] Adenocarcinoma, Papillary / immunology. Antigens, Neoplasm / metabolism. Kidney Neoplasms / immunology. Ureteral Neoplasms / immunology
  • [MeSH-minor] Aged. Female. Humans. Kidney Pelvis / pathology

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  • (PMID = 15733120.001).
  • [ISSN] 0919-8172
  • [Journal-full-title] International journal of urology : official journal of the Japanese Urological Association
  • [ISO-abbreviation] Int. J. Urol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Australia
  • [Chemical-registry-number] 0 / Antigens, Neoplasm
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4. Czito B, Zietman A, Kaufman D, Skowronski U, Shipley W: Adjuvant radiotherapy with and without concurrent chemotherapy for locally advanced transitional cell carcinoma of the renal pelvis and ureter. J Urol; 2004 Oct;172(4 Pt 1):1271-5
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  • [Title] Adjuvant radiotherapy with and without concurrent chemotherapy for locally advanced transitional cell carcinoma of the renal pelvis and ureter.
  • The role of adjuvant radiation therapy and chemotherapy is not well defined.
  • We retrospectively reviewed the records of 31 patients who underwent surgery followed by adjuvant radiotherapy with or without concurrent chemotherapy to determine overall outcome as well as impact of concurrent chemotherapy administration.
  • MATERIALS AND METHODS: Between 1970 and 1997, 31 patients with nonmetastatic transitional cell carcinoma of the upper urinary tract (renal pelvis in 13, ureter in 15, and renal pelvis and ureter in 3) were treated with radiotherapy following attempted curative resection.
  • The median radiation dose was 46.9 Gy.
  • Nine patients received methotrexate, cisplatin and vinblastine chemotherapy for 2 to 4 cycles, followed by concurrent cisplatin with radiation.
  • On univariate analysis patients had improved 5-year actuarial overall and disease specific survival with the administration of concurrent chemotherapy (27% vs 67%, p = 0.01 and 41% vs 76%, p = 0.06, respectively).
  • [MeSH-major] Carcinoma, Transitional Cell / drug therapy. Carcinoma, Transitional Cell / radiotherapy. Kidney Neoplasms / drug therapy. Kidney Neoplasms / radiotherapy. Kidney Pelvis. Ureteral Neoplasms / drug therapy. Ureteral Neoplasms / radiotherapy
  • [MeSH-minor] Actuarial Analysis. Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Adjuvant. Cisplatin / therapeutic use. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Metastasis / pathology. Neoplasm Recurrence, Local / pathology. Neoplasm Staging. Neoplasm, Residual / drug therapy. Neoplasm, Residual / pathology. Neoplasm, Residual / radiotherapy. Neoplasm, Residual / surgery. Outcome and Process Assessment (Health Care). Radiation-Sensitizing Agents / therapeutic use. Radiotherapy, Adjuvant. Survival Rate. Ureter / pathology. Ureter / surgery


5. Yasuda K, Kawa G, Kinoshita H, Matsuda T: [Port-site metastasis of an upper urinary tract urothelial carcinoma after laparoscopic nephroureterectomy: a case report]. Hinyokika Kiyo; 2009 Mar;55(3):141-4

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  • We report here a case of ureteral cancer in which port-site metastasis was suspected after a nephroureterectomy.
  • A tumor was found in his left renal pelvis and ureter by a computed tomographic (CT) scan.
  • He received two courses of MVAC chemotherapy (methotrexate 50 mg, vinblastine 5 mg, adriamycin 50mg, cisplatin 120 mg) postoperatively.
  • Since retroperitoneal lymph node metastasis was observed three months later on a CT scan, the MVAC chemotherapy was repeated for three courses.
  • Nine months later, a tumor was found in the hypodermic beside the port-site, and a needle biopsy confirmed a metastatic urothelial carcinoma.
  • He received two courses of GP chemotherapy (gemcitabine 4,250 mg, paclitaxel 225 mg).
  • [MeSH-major] Carcinoma, Transitional Cell / pathology. Carcinoma, Transitional Cell / surgery. Laparoscopy. Neoplasm Seeding. Nephrectomy. Ureter / surgery. Ureteral Neoplasms / pathology. Ureteral Neoplasms / surgery

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  • (PMID = 19378825.001).
  • [ISSN] 0018-1994
  • [Journal-full-title] Hinyokika kiyo. Acta urologica Japonica
  • [ISO-abbreviation] Hinyokika Kiyo
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] Japan
  • [Number-of-references] 17
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6. Helke C, May M, Hoschke B: [Gemcitabine and carboplatin chemotherapy in advanced transitional cell carcinoma in regard to patients with impaired renal function]. Aktuelle Urol; 2006 Sep;37(5):363-8
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  • [Title] [Gemcitabine and carboplatin chemotherapy in advanced transitional cell carcinoma in regard to patients with impaired renal function].
  • [Transliterated title] Gemcitabine/Carboplatin-Chemotherapie in der Behandlung des metastasierten Urothelkarzinoms unter besonderer Berücksichtigung von Patienten mit eingeschränkter Nierenfunktion.
  • PURPOSE: The aim of this analysis is the evaluation of the activity and toxicity of gemcitabine and carboplatin in patients with advanced urothelial transitional carcinoma (TCC) with special regard to patients with impaired renal function.
  • In 15 patients (considered as renal unfit) a creatinine clearance of less than 60 mL/min (range: 31 - 59 mL/min) was seen.
  • RESULTS: Concerning the survival rate, no significant difference noticed between the two subgroups of renal impaired patients and patients with normal renal function was detected (median 13 vs. 14 months, p = 0.901).
  • Median time to progression was 5.34 months.
  • There was no restriction of renal function under chemotherapy in any single patient.
  • CONCLUSIONS: The chemotherapy combination of gemcitabine and carboplatin is definitely powerful for a first-line-therapy in patients with advanced TCC.
  • Decreases of effectiveness in cases of impaired renal function were not detected.
  • Patients with metastatic TCC should be entered onto well designed, randomised clinical trials with the gemcitabine/carboplatin combination to afford a tailored chemotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carboplatin / administration & dosage. Carcinoma, Transitional Cell / drug therapy. Deoxycytidine / analogs & derivatives. Kidney Failure, Chronic / complications. Kidney Function Tests. Ureteral Neoplasms / drug therapy. Urinary Bladder Neoplasms / drug therapy
  • [MeSH-minor] Aged. Aged, 80 and over. Disease Progression. Dose-Response Relationship, Drug. Female. Follow-Up Studies. Humans. Kidney Pelvis / pathology. Male. Middle Aged. Neoplasm Invasiveness / pathology. Neoplasm Metastasis / pathology. Prospective Studies. Survival Rate. Ureter / pathology. Urinary Bladder / pathology


7. Takagi S, Gohji K, Iwamoto Y, Masuda H, Segawa N, Kiura H, Ueda H, Katsuoka Y: [Ureter cancer of complete double renal pelvis and ureter: a case report]. Hinyokika Kiyo; 2002 Dec;48(12):761-4
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  • [Title] [Ureter cancer of complete double renal pelvis and ureter: a case report].
  • Intravenous pyelography, computerized tomography and magnetic resonance imaging revealed ureteral tumors of the complete left double renal pelvis and the ureter.
  • An endoscopic examination disclosed a papillary tumor from the left ureteral orifice of the lower pole of the kidney.
  • A transurethral resection of the tumor was done, and the pathological features revealed transitional cell carcinoma (PTa, grade 2).
  • A left nephroureterectomy and a partial cystectomy were also carried out; macroscopic examinations showed a non-papillary tumor on the middle portion of the left ureter originating from the upper pole of the kidney.
  • Adjuvant chemotherapy (M-VAC) was administered but discontinued because of severe side effects.
  • Dispite recurrence with retro-peritoneal lymph node metastasis, the patient is alive and again undergoing M-VAC chemotherapy 22 months after the initial surgery.
  • However, the evaluation of the chemotherapy was "no change".
  • [MeSH-major] Carcinoma, Transitional Cell / surgery. Kidney Neoplasms / surgery. Kidney Pelvis / abnormalities. Neoplasms, Multiple Primary. Ureter / abnormalities. Ureteral Neoplasms / surgery
  • [MeSH-minor] Aged. Chemotherapy, Adjuvant. Humans. Lymphatic Metastasis. Male. Neoplasm Recurrence, Local. Urinary Bladder Neoplasms / pathology. Urinary Bladder Neoplasms / surgery. Urologic Surgical Procedures

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  • (PMID = 12613013.001).
  • [ISSN] 0018-1994
  • [Journal-full-title] Hinyokika kiyo. Acta urologica Japonica
  • [ISO-abbreviation] Hinyokika Kiyo
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] Japan
  • [Number-of-references] 16
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8. Shimizu Y: Chemotherapy of advanced or recurrent cervical carcinoma with a consecutive low-dose cisplatin combined with bleomycin, vincristine, and mitomycin-C (consecutive low-dose BOMP). Gan To Kagaku Ryoho; 2000 May;27 Suppl 2:359-77
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  • [Title] Chemotherapy of advanced or recurrent cervical carcinoma with a consecutive low-dose cisplatin combined with bleomycin, vincristine, and mitomycin-C (consecutive low-dose BOMP).
  • There are many problems encountered in devising chemotherapy for patients with advanced or recurrent cervical carcinoma, in part because the vast majority of such patients have received prior radiation therapy with or without radical hysterectomy.
  • Prior radiation therapy not only impairs bone marrow reserve but also interferes with the vascular supply to the tumor bed and delivery of the drug.
  • In addition, many of the patients with advanced or recurrent cervical carcinoma have ureteral obstruction with impaired renal excretion of certain agents, thus limiting the tolerance to these agents.
  • The authors have designed a new chemotherapy protocol utilizing a consecutive low-dose cisplatin to overcome the above difficulties.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Neoplasm Recurrence, Local / drug therapy. Uterine Cervical Neoplasms / drug therapy
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / pathology. Adult. Aged. Aged, 80 and over. Bleomycin / administration & dosage. Carcinoma, Adenosquamous / drug therapy. Carcinoma, Adenosquamous / pathology. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / pathology. Cisplatin / administration & dosage. Cisplatin / pharmacokinetics. Dose-Response Relationship, Drug. Drug Administration Schedule. Female. Humans. Middle Aged. Mitomycin / administration & dosage. Proportional Hazards Models. Survival Analysis. Vincristine / administration & dosage

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  • (PMID = 10895181.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] JAPAN
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 50SG953SK6 / Mitomycin; 5J49Q6B70F / Vincristine; Q20Q21Q62J / Cisplatin; BOMP protocol
  • [Number-of-references] 59
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9. Holmäng S, Thomsen J, Johansson SL: Micropapillary carcinoma of the renal pelvis and ureter. J Urol; 2006 Feb;175(2):463-6; discussion 466-7
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  • [Title] Micropapillary carcinoma of the renal pelvis and ureter.
  • MATERIALS AND METHODS: A clinical and histopathological review was performed in 943 patients with a neoplasm in the renal pelvis or ureter, diagnosed between 1971 and 1998.
  • CONCLUSIONS: The prognosis is poor since most patients with MPC of the renal pelvis and ureter initially present with advanced disease.
  • However, radiotherapy and systemic chemotherapy appear to be ineffective.
  • [MeSH-major] Carcinoma, Papillary. Kidney Neoplasms. Kidney Pelvis. Ureteral Neoplasms

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  • (PMID = 16406972.001).
  • [ISSN] 0022-5347
  • [Journal-full-title] The Journal of urology
  • [ISO-abbreviation] J. Urol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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10. Goel MC, Mahendra V, Roberts JG: Percutaneous management of renal pelvic urothelial tumors: long-term followup. J Urol; 2003 Mar;169(3):925-9; discussion 929-30
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  • [Title] Percutaneous management of renal pelvic urothelial tumors: long-term followup.
  • PURPOSE: We present the long-term outcome of percutaneous resection of renal urothelial tumor.
  • MATERIALS AND METHODS: A total of 24 patients underwent primary percutaneous resection of renal urothelial tumor.
  • Patients with multi-segmental pelvicaliceal system involvement, stage greater than pT1, high grade histology or additional ureteral tumors were considered for nephroureterectomy.
  • Topical chemotherapy (mitomycin C or epirubicin) was administered via nephrostomy tube or intravesical instillation after Double-J stent (Medical Engineering Corp., New York, New York) insertion.
  • RESULTS: Of the 24 cases 2 had squamous cell carcinoma, 5 had grade III transitional cell carcinoma, 15 had grade I to II transitional cell carcinoma and 2 had no tumor.
  • All patients with high grade disease died of malignancy except one (with no further treatment) and 6 of the 15 patients with low grade noninvasive transitional cell carcinoma underwent nephroureterectomy during followup either due to progression of disease, concomitant tumor or complications.
  • Two patients with solitary kidneys died of renal failure unrelated to malignancy.
  • All excised tracks from patients who underwent nephroureterectomy and the renal fossae were free of tumor on histopathological examination.
  • CONCLUSIONS: Percutaneous resection of transitional cell tumor should be considered primarily in patients with early stage disease excluding tumors crossing caliceal infundibula, ureteropelvic junction tumor, tumor extending over multiple calices and synchronous ureteral tumors.
  • [MeSH-major] Carcinoma, Transitional Cell / therapy. Kidney Neoplasms / therapy
  • [MeSH-minor] Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / therapy. Endoscopy. Female. Follow-Up Studies. Humans. Kidney Pelvis. Male. Middle Aged. Neoplasm Recurrence, Local. Nephrectomy. Ureter / surgery

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  • [CommentIn] J Urol. 2003 Mar;169(3):936-7 [12576816.001]
  • (PMID = 12576814.001).
  • [ISSN] 0022-5347
  • [Journal-full-title] The Journal of urology
  • [ISO-abbreviation] J. Urol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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11. Ozsahin M, Ugurluer G, Zouhair A: Management of transitional-cell carcinoma of the renal pelvis and ureter. Swiss Med Wkly; 2009 Jun 27;139(25-26):353-6
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  • [Title] Management of transitional-cell carcinoma of the renal pelvis and ureter.
  • Transitional-cell carcinoma of the renal pelvis or ureter is a relatively rare disease.
  • The treatment of renal pelvis and ureter tumours is open or laparoscopic surgery varying from conservative to more extensive surgical procedures, i.e. radical nephroureterectomy including removal of the contents of Gerota's fascia with ipsilateral ureter and a cuff of bladder at its distal extent.
  • Most available data are from retrospective studies and surgery is the mainstay of treatment.
  • Chemotherapy and/or radiation therapy are possible adjuvant or primary treatment for selected patients; however, prospective studies are needed to confirm their use.
  • [MeSH-major] Carcinoma, Transitional Cell / surgery. Kidney Neoplasms / surgery. Ureteral Neoplasms / surgery
  • [MeSH-minor] Female. Humans. Kidney Pelvis / pathology. Kidney Pelvis / surgery. Male. Neoplasm Staging. Nephrectomy

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  • (PMID = 19562529.001).
  • [ISSN] 1424-7860
  • [Journal-full-title] Swiss medical weekly
  • [ISO-abbreviation] Swiss Med Wkly
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Switzerland
  • [Number-of-references] 41
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12. Cetina L, Rivera L, Candelaria M, de la Garza J, Dueñas-González A: Chemoradiation with gemcitabine for cervical cancer in patients with renal failure. Anticancer Drugs; 2004 Sep;15(8):761-6
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  • [Title] Chemoradiation with gemcitabine for cervical cancer in patients with renal failure.
  • The prognosis of cervical cancer patients with renal failure secondary to obstructive uropathy is poor.
  • Our objective was to analyze our experience in the management with chemoradiation of untreated cervical cancer patients complicated by obstructive nephropathy and kidney dysfunction.
  • Untreated patients with cervical cancer and renal failure as manifested by raised serum creatinine were treated with pelvic radiotherapy concurrently with weekly gemcitabine at 300 mg/m2.
  • Response, toxicity and renal function pre- and post-therapy were evaluated.
  • Pre-treatment serum creatinine ranged from 1.6 to 18.5 mg/100 ml (median 3.3, mean 6.8) and creatinine clearance varied from 4 to 57 mg/ml/min (median 17, mean 22.1).
  • Four patients had a percutaneous nephrostomy placed and four patients had symptoms from kidney failure.
  • All patients had improvement in creatinine clearance (pre-therapy 22.78, post-therapy 54.3 mg/ml/min) (p=0.0058) and all but one normalized serum creatinine.
  • Ureteral obstruction causing any degree of renal insufficiency should not be a contraindication to receive chemoradiation to attempt cure.
  • In this setting where cisplatin-based therapy is contraindicated, the use of gemcitabine may be considered.
  • [MeSH-major] Chemotherapy, Adjuvant / methods. Deoxycytidine / analogs & derivatives. Deoxycytidine / therapeutic use. Radiotherapy, Adjuvant / methods. Renal Insufficiency / drug therapy. Uterine Cervical Neoplasms / drug therapy. Uterine Cervical Neoplasms / radiotherapy
  • [MeSH-minor] Brachytherapy / methods. Carcinoma, Squamous Cell / complications. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Creatinine / blood. Drug Administration Schedule. Drug Evaluation / methods. Female. Follow-Up Studies. Humans. Injections, Intravenous. Kidney Function Tests / methods. Mexico. Middle Aged. Neoplasm Staging. Radiation-Sensitizing Agents / administration & dosage. Radiation-Sensitizing Agents / adverse effects. Radiation-Sensitizing Agents / therapeutic use. Time Factors. Treatment Outcome. Urethral Obstruction / complications

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  • (PMID = 15494637.001).
  • [ISSN] 0959-4973
  • [Journal-full-title] Anti-cancer drugs
  • [ISO-abbreviation] Anticancer Drugs
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Radiation-Sensitizing Agents; 0W860991D6 / Deoxycytidine; AYI8EX34EU / Creatinine; B76N6SBZ8R / gemcitabine
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13. Park BK, Kim CK: Percutaneous radio frequency ablation of renal tumors in patients with von Hippel-Lindau disease: preliminary results. J Urol; 2010 May;183(5):1703-7
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  • [Title] Percutaneous radio frequency ablation of renal tumors in patients with von Hippel-Lindau disease: preliminary results.
  • PURPOSE: We investigated the preliminary results of percutaneous radio frequency ablation for renal tumors in patients with von Hippel-Lindau disease.
  • MATERIALS AND METHODS: Between October 2005 and April 2009 image guided radio frequency ablation was performed to ablate a total of 48 renal tumors in 11 patients with von Hippel-Lindau disease.
  • Six of the 11 patients had undergone radical or partial nephrectomy for renal cell carcinomas.
  • Two residual tumors were treated with nephrectomy, 2 were too small to be ablated and 1 was treated with chemotherapy due to pulmonary metastasis.
  • The remaining residual tumor was completely ablated at 2 sessions but recurred.
  • Two major complications (6.9%) developed at a total of 29 sessions, including arteriovenous fistula and ureteral perforation.
  • CONCLUSIONS: Percutaneous radio frequency ablation may be a treatment option for multifocal renal tumors in patients with von Hippel-Lindau disease but preliminary results were not satisfactory due to technical failure.
  • [MeSH-major] Carcinoma, Renal Cell / surgery. Catheter Ablation / methods. Kidney Neoplasms / surgery. von Hippel-Lindau Disease / surgery
  • [MeSH-minor] Adult. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / surgery. Neoplasm, Residual / surgery. Nephrectomy. Postoperative Complications. Retrospective Studies. Statistics, Nonparametric. Treatment Outcome

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  • [Copyright] 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
  • (PMID = 20299060.001).
  • [ISSN] 1527-3792
  • [Journal-full-title] The Journal of urology
  • [ISO-abbreviation] J. Urol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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14. Miao M, Kong CZ, Li ZH, Liu XK, Sun ZX: [The clinical study for reducing bladder cancer recurrence after surgical treatment for renal pelvic carcinoma]. Zhonghua Wai Ke Za Zhi; 2009 May 15;47(10):728-30
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  • [Title] [The clinical study for reducing bladder cancer recurrence after surgical treatment for renal pelvic carcinoma].
  • OBJECTIVE: To investigate the clinical methods for reducing bladder cancer recurrence after surgical treatment for renal pelvic carcinoma.
  • METHODS: From October 1997 to December 2007, the data of 227 patients undergoing total nephroureterectomy for clinically localized transitional cell carcinoma of the renal pelvis with follow-up results were analyzed retrospectively, including 126 cases of male and 101 cases of female, and the age was 34 to 78 years old.
  • There were 2 kinds of technique used in the dissection of bladder wall circumferentially around the ureteral orifice.
  • Technique A was dissection along the ipsilateral ureter to the bladder wall.
  • Technique B was dissection along the vas deferens to the bladder wall circumferentially around the ipsilateral ureteral orifice and division of the lateral vesical ligament to reach the seminal vesicle.
  • Prophylactic intravesical chemotherapy included 3 method.
  • Method 1 was intraoperative intravesical chemotherapy and then administrated once a week, 10 times in total.
  • Method 2 was intraoperative intravesical chemotherapy and then administrated once a week from the 4(th) week after operation, 10 times in total.
  • Method 3 was intravesical chemotherapy was given once a week from the 4(th) week after operation, 10 times in total.
  • The time of follow-up was 1 to 10 years with regular cystoscopy.
  • The postoperative recurrence rates of bladder cancer in patients using 3 kinds of intravesical chemotherapy regimen were 17.9% (11/67), 20.8% (10/48) and 33.3% (17/51), respectively.
  • There was significant difference between the recurrence rates of patients using method 1 and method 3 intravesical chemotherapy (P < 0.05).
  • CONCLUSION: Complete removal of the bladder mucosa circumferentially around the ureteral orifice, administration of the intraoperative intravesical chemotherapy instillation and instillation once a week may be a useful approach to reduce the recurrence of bladder cancer after operation for renal pelvic carcinoma.
  • [MeSH-major] Carcinoma, Renal Cell / surgery. Kidney Neoplasms / surgery. Kidney Pelvis. Urinary Bladder Neoplasms / secondary
  • [MeSH-minor] Adult. Aged. Chemotherapy, Cancer, Regional Perfusion. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / prevention & control. Postoperative Care. Retrospective Studies

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  • (PMID = 19615202.001).
  • [ISSN] 0529-5815
  • [Journal-full-title] Zhonghua wai ke za zhi [Chinese journal of surgery]
  • [ISO-abbreviation] Zhonghua Wai Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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15. Tokar M, Rogachev B, Levi I, Yerushalmi R, Ariad S, Geffen DB: Rituximab in a patient with acute renal failure due to B-cell lymphomatous infiltration of the kidneys. Leuk Lymphoma; 2004 Apr;45(4):819-20
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  • [Title] Rituximab in a patient with acute renal failure due to B-cell lymphomatous infiltration of the kidneys.
  • Renal failure is known to occur in lymphoproliferative disorders because of ureteral obstruction or parenchymal infiltration by disease.
  • The extent of renal clearance is not fully known, with little experience reported on the use of rituximab in patients with renal failure.
  • We present a case where rituximab was administered to a patient with acute renal failure due to bilateral kidney infiltration by non-Hodgkin's lymphoma (NHL).
  • The patients renal function improved on therapy, with no need for hemodialysis and there were no significant toxicities.
  • Rituximab may be used as a treatment option for NHL patients with impaired renal function.
  • [MeSH-major] Acute Kidney Injury / etiology. Kidney / pathology. Lymphoma, B-Cell / complications. Lymphoma, B-Cell / drug therapy
  • [MeSH-minor] Adult. Antibodies, Monoclonal. Antibodies, Monoclonal, Murine-Derived. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Humans. Male. Mitoxantrone / therapeutic use. Neoplasm Invasiveness. Remission Induction / methods. Rituximab. Treatment Outcome

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  • (PMID = 15160963.001).
  • [ISSN] 1042-8194
  • [Journal-full-title] Leukemia & lymphoma
  • [ISO-abbreviation] Leuk. Lymphoma
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Murine-Derived; 4F4X42SYQ6 / Rituximab; BZ114NVM5P / Mitoxantrone
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16. Vecchioli Scaldazza C, Giacomini G: [Repeated bladder metastases from renal cell carcinoma. Report of a case with particular attention to the use of immunomodulators]. Minerva Urol Nefrol; 2000 Dec;52(4):215-8
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  • [Title] [Repeated bladder metastases from renal cell carcinoma. Report of a case with particular attention to the use of immunomodulators].
  • The case of repeated metastases of the bladder from renal cell carcinoma in a 59 year old male patient is presented.
  • Two years after nephrectomy the ureteral stump and the bladder were interested by two different metastases.
  • Afterwards, other nine metastases developed into the bladder during the following 12 months.
  • No report was found in the literature about BCG in the treatment of superficial bladder metastases from renal cell carcinoma.
  • However 15 months from beginning of BCG treatment no metastasis developed from the bladder that now is disease-free after a follow-up of 19 months.
  • [MeSH-major] Adjuvants, Immunologic / therapeutic use. BCG Vaccine / therapeutic use. Carcinoma, Renal Cell / drug therapy. Carcinoma, Renal Cell / secondary. Kidney Neoplasms / drug therapy. Neoplasm Recurrence, Local / drug therapy. Urinary Bladder Neoplasms / drug therapy. Urinary Bladder Neoplasms / secondary

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  • (PMID = 11315333.001).
  • [ISSN] 0393-2249
  • [Journal-full-title] Minerva urologica e nefrologica = The Italian journal of urology and nephrology
  • [ISO-abbreviation] Minerva Urol Nefrol
  • [Language] ita
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Adjuvants, Immunologic; 0 / BCG Vaccine
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17. Troiano M, Corsa P, Raguso A, Cossa S, Piombino M, Guglielmi G, Parisi S: Radiation therapy in urinary cancer: state of the art and perspective. Radiol Med; 2009 Feb;114(1):70-82

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  • [Title] Radiation therapy in urinary cancer: state of the art and perspective.
  • Invasive urinary tumours are relatively rare, and their treatment may cause important changes in urinary, sexual and social functions.
  • A systematic review of external radiation therapy studies in urinary cancers was performed.
  • There are few controlled clinical trials using adjuvant or radical radiotherapy with or without chemotherapy in cancer of the kidney, ureter and urethra.
  • There are several reports on multimodality treatment in invasive bladder cancer: intravesical surgery and neoadjuvant chemotherapy to radiotherapy or concomitant radiochemotherapy with organ preservation.
  • The conclusions reached for renal cancer are controversial, and data on cancers of the urethra and ureter are few and inconclusive.
  • [MeSH-minor] Brachytherapy. Combined Modality Therapy. Controlled Clinical Trials as Topic. Cystectomy. Data Interpretation, Statistical. Dose Fractionation. Female. Humans. Kidney / pathology. Kidney Neoplasms / mortality. Kidney Neoplasms / pathology. Kidney Neoplasms / radiotherapy. Kidney Neoplasms / surgery. Male. Meta-Analysis as Topic. Neoplasm Staging. Nephrectomy. Organ Preservation. Prospective Studies. Radiotherapy Dosage. Radiotherapy, Adjuvant. Retrospective Studies. Survival Analysis. Time Factors. Ureter / pathology. Ureteral Neoplasms / drug therapy. Ureteral Neoplasms / mortality. Ureteral Neoplasms / pathology. Ureteral Neoplasms / radiotherapy. Urethra / pathology. Urethral Neoplasms / drug therapy. Urethral Neoplasms / mortality. Urethral Neoplasms / pathology. Urethral Neoplasms / radiotherapy. Urinary Bladder / pathology. Urinary Bladder Neoplasms / pathology. Urinary Bladder Neoplasms / radiotherapy. Urinary Bladder Neoplasms / surgery

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  • (PMID = 19082788.001).
  • [ISSN] 0033-8362
  • [Journal-full-title] La Radiologia medica
  • [ISO-abbreviation] Radiol Med
  • [Language] eng; ita
  • [Publication-type] Comparative Study; Journal Article; Review
  • [Publication-country] Italy
  • [Number-of-references] 80
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18. Sakuma T, Ujike T, Yoshida T, Ohashi H, Kawano K: [Urothelial carcinoma of ureter with neuroendocrine differentiation: a case report]. Hinyokika Kiyo; 2008 Feb;54(2):123-6
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  • [Title] [Urothelial carcinoma of ureter with neuroendocrine differentiation: a case report].
  • Cystoscopy revealed a bladder tumor around the right ureteral orifice.
  • TUR biopsy of the bladder tumor was SmCC.
  • With laparoscopic nephrectomy/open ureterectomy, distal end (approximately 10 cm) of the right ureter was tumorous and obstructed.
  • The tumor invaded into the urinary bladder/peritoneum and was unresectable.
  • The tumor of lower-end of ureter tumor was SmCC, showing neuroendocrine differentiation such as pseudo-rosette, positive Grimelius stain, and chromogranin A/NCAM/synaptophysin immunostaining.
  • Proximal to this tumor, non-invasive UC spread superficially over entire length of the ureter to the renal pelvis.
  • Abrupt transition from invasive SmCC to non-invasive UC was observed in the middle of the ureter.
  • Post-operative adjuvant chemotherapy was discouraged due to senile dementia of the patient.
  • [MeSH-major] Carcinoma, Neuroendocrine / pathology. Carcinoma, Small Cell / pathology. Ureteral Neoplasms / pathology
  • [MeSH-minor] Aged. Female. Humans. Neoplasm Invasiveness. Urothelium / pathology

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  • (PMID = 18323171.001).
  • [ISSN] 0018-1994
  • [Journal-full-title] Hinyokika kiyo. Acta urologica Japonica
  • [ISO-abbreviation] Hinyokika Kiyo
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
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19. Chen WJ, Kuo JY, Chen KK, Lin AT, Chang YH, Chang LS: Primary urothelial carcinoma of the ureter: 11-year experience in Taipei Veterans General Hospital. J Chin Med Assoc; 2005 Nov;68(11):522-30

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  • [Title] Primary urothelial carcinoma of the ureter: 11-year experience in Taipei Veterans General Hospital.
  • Ureteral urothelial carcinoma is even less common than that of the renal pelvis, accounting for about 25% of all upper urinary tract tumors.
  • The aim of this study was to evaluate the clinical behavior, survival, recurrence and prognostic information of primary ureteral urothelial carcinoma from our 11 years of experience at the Taipei Veterans General Hospital.
  • METHODS: We retrospectively reviewed 111 patients with ureteral urothelial carcinoma who had been treated in our hospital between January 1993 and December 2003.
  • Tumor staging was according to the 2002 AJCC TNM classification and stage groupings.
  • Nephroureterectomy with bladder cuff excision was performed in 78 patients, 12 patients received segmental resection of the ureter, 4 received ureteroscopic laser coagulation, and 17 underwent chemotherapy or radiotherapy or both.
  • Disease recurrence in the nephroureterectomy group occurred in 36 patients (46.2%), with 17 (21.8%) at the urinary bladder, 2 (2.6%) at the retroperitoneum, 1 (1.3%) at the contralateral ureter, 6 (7.7%) with distant metastases to the lung, bone, distant lymph nodes or liver, and 10 (12.8%) at multiple sites.
  • Significant prognostic factors for cancer-specific survival by univariate analysis were pT (p = 0.00001), stage (p = 0.00001), type of treatment (p = 0.00001) and grade (p = 0.0001).
  • Tumor stage and grade are the only significant prognostic factors for both cancer-specific and overall survival.
  • [MeSH-major] Ureteral Neoplasms / mortality
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Retrospective Studies. Survival Rate

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  • (PMID = 16323396.001).
  • [ISSN] 1726-4901
  • [Journal-full-title] Journal of the Chinese Medical Association : JCMA
  • [ISO-abbreviation] J Chin Med Assoc
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] China (Republic : 1949- )
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20. Oka H, Shiraishi Y, Negoro H, Iwamura H, Moroi S, Soeda A, Takeuchi H, Kawakita M: [Clinical review of conservative management of upper urinary tract transitional cell carcinoma]. Hinyokika Kiyo; 2006 Apr;52(4):249-53
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  • We reviewed 18 patients with transitional cell carcinoma of the renal pelvis and ureter undergoing nephron-sparing surgery between April 1990 and Febrary 2003.
  • The tumor site was the renal pelvis in 2, ureter in 13 and ureteral orfice in 2.
  • Eight patients underwent endourological treatment and 10 patients open surgery including partial ureterectomy performed on 8 patient.
  • In the patients with tumors pT2 or higher and/or grade 3, the prognosis was poor which suggests the need for intensive therapy including lymph node dissection and/or adjuvant chemotherapy.
  • [MeSH-major] Carcinoma, Transitional Cell / surgery. Kidney Neoplasms / surgery. Kidney Pelvis. Nephrectomy / methods. Ureteral Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Male. Middle Aged. Neoplasm Staging. Prognosis. Survival Rate. Ureter / surgery

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  • (PMID = 16686350.001).
  • [ISSN] 0018-1994
  • [Journal-full-title] Hinyokika kiyo. Acta urologica Japonica
  • [ISO-abbreviation] Hinyokika Kiyo
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Japan
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21. Favaretto RL, Shariat SF, Chade DC, Godoy G, Adamy A, Kaag M, Bochner BH, Coleman J, Dalbagni G: The effect of tumor location on prognosis in patients treated with radical nephroureterectomy at Memorial Sloan-Kettering Cancer Center. Eur Urol; 2010 Oct;58(4):574-80
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  • [Title] The effect of tumor location on prognosis in patients treated with radical nephroureterectomy at Memorial Sloan-Kettering Cancer Center.
  • BACKGROUND: The prognostic impact of primary tumor location on outcomes for patients with upper-tract urothelial carcinoma (UTUC) is still contentious.
  • OBJECTIVE: To test the association between tumor location and disease recurrence and cancer-specific survival (CSS) in patients treated with radical nephroureterectomy (RNU) for UTUC.
  • Patients who had previous radical cystectomy, preoperative chemotherapy, previous contralateral UTUC, or metastatic disease at presentation were excluded.
  • Tumor location was categorized as renal pelvis or ureter based on the location of the dominant tumor.
  • Tumor location was not an independent predictor for recurrence (hazard ratio: 1.19; p=0.3), and there was no difference in the probability of disease recurrence between ureteral and renal pelvic tumors (p=0.18).
  • On survival analysis, we also found no differences between ureteral and renal pelvic tumors on probability of CSS (p=0.2).
  • CONCLUSIONS: Our study did not show any differences in recurrence and CSS rates between patients with ureteral and renal pelvic tumors treated with RNU.
  • [MeSH-major] Carcinoma, Transitional Cell / surgery. Kidney Neoplasms / surgery. Kidney Pelvis. Nephrectomy. Ureter / surgery. Ureteral Neoplasms / surgery
  • [MeSH-minor] Aged. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / epidemiology. Prognosis. Retrospective Studies. Survival Rate

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  • [Copyright] Copyright 2010 European Association of Urology. Published by Elsevier B.V. All rights reserved.
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  • (PMID = 20637540.001).
  • [ISSN] 1873-7560
  • [Journal-full-title] European urology
  • [ISO-abbreviation] Eur. Urol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / T32 CA082088
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
  • [Other-IDs] NLM/ NIHMS628548; NLM/ PMC4174409
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22. Segawa N, Azuma H, Takahara K, Hamada S, Kotake Y, Tsuji M, Katsuokai Y: [Port-site metastasis after retroperitoneoscopy-assisted nephroureterectomy and cystectomy for bladder cancer invading the ureter: a case report]. Hinyokika Kiyo; 2008 Jan;54(1):13-6
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  • [Title] [Port-site metastasis after retroperitoneoscopy-assisted nephroureterectomy and cystectomy for bladder cancer invading the ureter: a case report].
  • He received two courses of chemotherapy (methotrexate, vinblastine, adriamycin, cisplatin), and this resulted in resolution of the bone metastases.
  • Two months later, abdominal and pelvic computed tomography showed a bladder tumor invading the left lower ureter with hydronephrosis.
  • The patient was unable to undergo systemic chemotherapy because of renal dysfunction.
  • Four months later, a lateral abdominal wall tumor was found at a port-site, and needle biopsy confirmed this to be metastatic urothelial carcinoma.
  • [MeSH-major] Abdominal Neoplasms / secondary. Carcinoma / surgery. Cystectomy. Endoscopy. Neoplasm Invasiveness. Neoplasm Seeding. Nephrectomy. Ureter / surgery. Ureteral Neoplasms / surgery. Urinary Bladder Neoplasms / surgery

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  • (PMID = 18260354.001).
  • [ISSN] 0018-1994
  • [Journal-full-title] Hinyokika kiyo. Acta urologica Japonica
  • [ISO-abbreviation] Hinyokika Kiyo
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
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23. Kmetec A, Kaplan-Pavlovcic S, Ovcak Z: Transitional cell carcinoma involving the ureterovesical part of a transplanted ureter. Urol Int; 2003;71(1):122-3
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  • [Title] Transitional cell carcinoma involving the ureterovesical part of a transplanted ureter.
  • Ureterovesical malignancy in the renal transplant recipient is an infrequent occurrence.
  • We report a woman with a cadaver kidney recipient, transplanted 10 years ago, with transitional-cell carcinoma at the ureterovesical part of the transplanted ureter invading the bladder muscle around the orifice.
  • Though aggressive surgery and chemotherapy of such patients is proposed, most patients die after an average of 16-17 months.
  • In our patient we have done partial ureter and bladder resection in order to preserve kidney graft and bladder.
  • We continued immunosuppressive treatment.
  • Our case suggests that nonaggressive operative treatment without chemotherapy in selected patients may provide comparable survival to patients with aggressive treatment, but with better quality of life.
  • [MeSH-major] Carcinoma, Transitional Cell / pathology. Kidney Transplantation / adverse effects. Ureter / transplantation. Ureteral Neoplasms / pathology. Urinary Bladder Neoplasms / pathology. Urologic Surgical Procedures / methods
  • [MeSH-minor] Female. Humans. Middle Aged. Neoplasm Invasiveness. Transplants / adverse effects. Urography

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  • [Copyright] Copyright 2003 S. Karger AG, Basel
  • (PMID = 12845277.001).
  • [ISSN] 0042-1138
  • [Journal-full-title] Urologia internationalis
  • [ISO-abbreviation] Urol. Int.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Switzerland
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24. Washino S, Terauchi F, Matsuzaki A, Kobayashi Y: [Two cases of squamous cell carcinoma of upper urinary tract with hypercalcemia]. Nihon Hinyokika Gakkai Zasshi; 2008 Sep;99(6):703-8
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  • Case 1; a 54 year old female with primary squamous cell carcinoma (SCC) of right ureter showed marked hypercalcemia and leukocytosis.
  • Although chemotherapy of cisplatin and 5-fluorouracil with radiotherapy was effective, thereafter recurrence was occurred in renal pelvis, and the patient died 17 months after the initiation of therapy.
  • Case 2; a 54 year old male of primary SCC of right renal pelvis with local lymphadenopathy and anterior mediastinal metastases showed marked hypercalcemia.
  • Although the patient was administered UFT with palliative radiotherapy to the anterior mediastinum, he died 2 months after the initiation of therapy.
  • [MeSH-major] Carcinoma, Squamous Cell / complications. Hypercalcemia / etiology. Kidney Neoplasms / complications. Kidney Pelvis. Ureteral Neoplasms / complications
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / administration & dosage. Combined Modality Therapy. Fatal Outcome. Female. Fluorouracil / administration & dosage. Granulocyte Colony-Stimulating Factor / biosynthesis. Granulocyte Colony-Stimulating Factor / blood. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Parathyroid Hormone-Related Protein / biosynthesis. Parathyroid Hormone-Related Protein / blood. Radiotherapy. Tegafur / administration & dosage. Uracil / administration & dosage

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  • (PMID = 18939454.001).
  • [ISSN] 0021-5287
  • [Journal-full-title] Nihon Hinyōkika Gakkai zasshi. The japanese journal of urology
  • [ISO-abbreviation] Nippon Hinyokika Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Parathyroid Hormone-Related Protein; 143011-72-7 / Granulocyte Colony-Stimulating Factor; 1548R74NSZ / Tegafur; 56HH86ZVCT / Uracil; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil; 1-UFT protocol
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25. Raman JD, Ng CK, Scherr DS, Margulis V, Lotan Y, Bensalah K, Patard JJ, Kikuchi E, Montorsi F, Zigeuner R, Weizer A, Bolenz C, Koppie TM, Isbarn H, Jeldres C, Kabbani W, Remzi M, Waldert M, Wood CG, Roscigno M, Oya M, Langner C, Wolf JS, Ströbel P, Fernández M, Karakiewcz P, Shariat SF: Impact of tumor location on prognosis for patients with upper tract urothelial carcinoma managed by radical nephroureterectomy. Eur Urol; 2010 Jun;57(6):1072-9
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  • [Title] Impact of tumor location on prognosis for patients with upper tract urothelial carcinoma managed by radical nephroureterectomy.
  • BACKGROUND: There is a lack of consensus regarding the prognostic significance of ureteral versus renal pelvic upper tract urothelial carcinoma (UTUC).
  • OBJECTIVE: To investigate the association of tumor location on outcomes for UTUC in an international cohort of patients managed by radical nephroureterectomy (RNU).
  • MEASUREMENTS: Data accrued included age, gender, race, surgical approach (open vs laparoscopic), tumor pathology (stage, grade, lymph node status), tumor location, use of perioperative chemotherapy, prior endoscopic therapy, urothelial carcinoma recurrence, and mortality from urothelial carcinoma.
  • Tumor location was divided into two groups (renal pelvis and ureter) based on the location of the dominant tumor.
  • On multivariate analysis, only pathologic tumor (pT) classification (p<0.001), grade (p<0.02), and lymph node status (p<0.001) were associated with disease recurrence and cancer-specific survival.
  • When adjusting for these variables, there was no difference in the probability of disease recurrence (hazard ratio [HR]: 1.22; p=0.133) or cancer death (HR: 1.23; p=0.25) between ureteral and renal pelvic tumors.
  • Adding tumor location to a base prognostic model for disease recurrence and cancer death that included pT stage, tumor grade, and lymph node status only improved the predictive accuracy of this model by 0.1%.
  • CONCLUSIONS: There is no difference in outcomes between patients with renal pelvic tumors and with ureteral tumors following nephroureterectomy.
  • These data support the current TNM staging system, whereby renal pelvic and ureteral carcinomas are classified as one integral group of tumors.
  • [MeSH-major] Carcinoma / pathology. Kidney Neoplasms / pathology. Kidney Pelvis / pathology. Ureter / pathology. Urethral Neoplasms / pathology. Urothelium / pathology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Kaplan-Meier Estimate. Male. Middle Aged. Multicenter Studies as Topic. Neoplasm Staging. Nephrectomy. Prognosis. Proportional Hazards Models. Recurrence. Retrospective Studies

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  • [Copyright] Copyright © 2009 European Association of Urology. Published by Elsevier B.V. All rights reserved.
  • (PMID = 19619934.001).
  • [ISSN] 1873-7560
  • [Journal-full-title] European urology
  • [ISO-abbreviation] Eur. Urol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
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26. Neville H, Ritchey ML, Shamberger RC, Haase G, Perlman S, Yoshioka T: The occurrence of Wilms tumor in horseshoe kidneys: a report from the National Wilms Tumor Study Group (NWTSG). J Pediatr Surg; 2002 Aug;37(8):1134-7
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  • [Title] The occurrence of Wilms tumor in horseshoe kidneys: a report from the National Wilms Tumor Study Group (NWTSG).
  • BACKGROUND/PURPOSE: An increased incidence of Wilms tumor has been noted in patients with a horseshoe kidney.
  • These represent a difficult diagnostic and therapeutic challenge.
  • The charts of all National Wilms Tumor Study Group (NWTSG) patients with Wilms tumor occurring in a horseshoe kidney were reviewed.
  • Forty-one patients were found to have a Wilms tumor arising in a horseshoe kidney for an incidence of 0.48%.
  • RESULTS: Horseshoe kidney was not recognized preoperatively in 13 patients, 10 of whom were evaluated with computed tomography (CT).
  • Four of the 10 also had renal ultrasonography and one an intravenous pyelogram (IVP).
  • Fifteen children were treated with preoperative chemotherapy after initial biopsy of the tumor.
  • The mean total remaining renal parenchyma after all operations (excluding treatment of relapses) was approximately 75%.
  • Surgical complications occurred in 14.6% of patients, including 2 urine leaks, 2 ureteral obstructions, and 1 ureteral injury.
  • Two patients had transient renal failure.
  • CONCLUSIONS: The diagnosis of horseshoe kidney often was missed on preoperative imaging.
  • Although 37% of patients with Wilms tumor arising in a horseshoe kidney were judged inoperable at initial exploration, all were amenable to resection after chemotherapy.
  • [MeSH-major] Congenital Abnormalities / epidemiology. Kidney / abnormalities. Kidney Neoplasms / epidemiology. Wilms Tumor / epidemiology
  • [MeSH-minor] Biopsy. Chemotherapy, Adjuvant. Child, Preschool. Comorbidity. Female. Humans. Incidence. Male. Neoplasm Staging. Nephrectomy. Premedication. Retrospective Studies. Survival Rate. Tomography, X-Ray Computed

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  • [Copyright] Copyright 2002, Elsevier Science (USA). All rights reserved.
  • (PMID = 12149688.001).
  • [ISSN] 1531-5037
  • [Journal-full-title] Journal of pediatric surgery
  • [ISO-abbreviation] J. Pediatr. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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27. Thalmann GN, Markwalder R, Walter B, Studer UE: Long-term experience with bacillus Calmette-Guerin therapy of upper urinary tract transitional cell carcinoma in patients not eligible for surgery. J Urol; 2002 Oct;168(4 Pt 1):1381-5
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  • [Title] Long-term experience with bacillus Calmette-Guerin therapy of upper urinary tract transitional cell carcinoma in patients not eligible for surgery.
  • PURPOSE: Carcinoma in situ and urothelial tumors of the upper urinary tract become problematic in cases of bilateral occurrence or solitary kidney.
  • Perfusions with bacillus Calmette-Guerin (BCG) have been reported beneficial, however, only long-term results will determine the validity of this treatment.
  • MATERIALS AND METHODS: We retrospectively evaluated the results of BCG therapy for upper urinary tract disease in 37 patients.
  • All 37 patients had undergone previous surgical treatment for urothelial cancer, had a positive cytology or biopsy for upper urinary tract cancer and were ineligible for radical nephroureterectomy with a bladder cuff.
  • After placement of a 10Fr nephrostomy tube with the patient under local anesthesia 6 weekly perfusions of BCG were administered after radiological documentation of unhindered flow from the renal pelvis to the bladder or urinary diversion.
  • A total of 25 renal units were treated with curative intent for carcinoma in situ and 16 renal units were treated for Ta or higher urothelial tumors in an adjuvant setting after endoscopic resection.
  • RESULTS: In 37 patients 41 renal units were treated with BCG perfusions and were followed for a median of 42 months (range 8 to 137).
  • In 1 patient BCG inflammation and in 2 others severe septicemia developed after the first perfusion.
  • There was no tumor seeding along the nephrostomy tract in any patient.
  • BCG perfusion therapy did not alter renal function.
  • CONCLUSIONS: BCG perfusion therapy of the upper urinary tract for papillary tumors or carcinoma in situ is a valid treatment option with acceptable side effects for patients not amenable to conventional radical surgical therapy.
  • BCG therapy of upper urinary tract urothelial tumors may prevent patients from requiring dialysis and provides cure in those with carcinoma in situ of the upper urinary tract.
  • In this negatively selected patient population BCG buys time for some but does not provide cure except for carcinoma in situ.
  • [MeSH-major] BCG Vaccine / therapeutic use. Carcinoma in Situ / drug therapy. Carcinoma, Transitional Cell / drug therapy. Kidney Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Disease-Free Survival. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / drug therapy. Neoplasm Recurrence, Local / surgery. Neoplasm Staging. Nephrectomy. Nephrostomy, Percutaneous. Perfusion. Retrospective Studies. Survival Rate. Ureter / pathology. Ureter / surgery. Ureteral Neoplasms / drug therapy. Ureteral Neoplasms / mortality. Ureteral Neoplasms / pathology. Ureteral Neoplasms / surgery. Urinary Bladder Neoplasms / drug therapy. Urinary Bladder Neoplasms / mortality. Urinary Bladder Neoplasms / pathology. Urinary Bladder Neoplasms / surgery. Urinary Diversion

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  • (PMID = 12352398.001).
  • [ISSN] 0022-5347
  • [Journal-full-title] The Journal of urology
  • [ISO-abbreviation] J. Urol.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / BCG Vaccine
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28. Kaufman DS, Carducci MA, Kuzel TM, Todd MB, Oh WK, Smith MR, Ye Z, Nicol SJ, Stadler WM: A multi-institutional phase II trial of gemcitabine plus paclitaxel in patients with locally advanced or metastatic urothelial cancer. Urol Oncol; 2004 Sep-Oct;22(5):393-7
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  • Patients with adequate organ function and performance status were accrued through 7 institutions, stratified by prior therapy status, and treated as noted.
  • Insufficient patients with poor renal function or prior therapy were accrued to reach conclusions regarding its utility in these subgroups.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Deoxycytidine / analogs & derivatives. Ureteral Neoplasms / drug therapy. Urinary Bladder Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Female. Humans. Infusions, Intravenous. Kidney / physiology. Male. Middle Aged. Neoplasm Metastasis. Paclitaxel / administration & dosage. Survival Analysis. Treatment Outcome

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  • (PMID = 15464919.001).
  • [ISSN] 1078-1439
  • [Journal-full-title] Urologic oncology
  • [ISO-abbreviation] Urol. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0W860991D6 / Deoxycytidine; B76N6SBZ8R / gemcitabine; P88XT4IS4D / Paclitaxel
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29. Jabbour ME, Smith AD: Primary percutaneous approach to upper urinary tract transitional cell carcinoma. Urol Clin North Am; 2000 Nov;27(4):739-50
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  • A routine nephroureterectomy for every filling defect in the upper urinary system, even in the case of a normal contralateral kidney, constitutes an unnecessary mutilation in more than two thirds of the cases.
  • Nephroureterectomy does not reduce the need for a long-term cystoscopic follow-up because of the high rate of bladder tumor recurrence that may happen years later after nephroureterectomy.
  • Biopsy specimens taken with ureteroscopy may be sufficient for grading but less adequate for staging of the tumor.
  • The authors reserve ureteroscopy for ureteral tumors and small (< 1.5 cm) single tumors of the renal pelvis.
  • They approach large or multiple tumors of the renal pelvis percutaneously, in which a full histologic assessment is possible along with a complete resection of the tumor.
  • The decision on the therapeutic approach is made only after the final pathologic report is reviewed.
  • The indications for endourologic treatment in these cases can be extended safely beyond a solitary kidney or a high surgical risk to include any healthy individual with a normal contralateral kidney who is willing to commit to a rigorous lifelong follow-up.
  • When criteria of good prognosis are found, such as absence of carcinoma in situ, presence of diploidy, low p53 expression and a single-tumor, endoscopic management can be offered [table: see text] with a closer follow-up and resorting always to immediate nephroureterectomy at the first evidence of upstaging.
  • Endoscopic conservative surgery still can be offered in the cases of a solitary kidney or chronic renal insufficiency or for poor surgical candidates.
  • Although the tissue removed may include deep layers, deep resection is precluded by the thin renal pelvic wall and the associated risk for perforation.
  • Patients with more extensive disease (T3, T4) have a bad prognosis regardless of the form of therapy.
  • Achieving local control percutaneously while preserving as many nephrons as possible for the future chemotherapy can be a reasonable option.
  • [MeSH-minor] Humans. Neoplasm Recurrence, Local / prevention & control. Ureteroscopy

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  • (PMID = 11098771.001).
  • [ISSN] 0094-0143
  • [Journal-full-title] The Urologic clinics of North America
  • [ISO-abbreviation] Urol. Clin. North Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] UNITED STATES
  • [Number-of-references] 93
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30. Kaneko T, Fujita K, Homma Y: Transient anuria requiring nephrostomy after intravesical bacillus Calmette-Guérin instillations for superficial bladder cancer. Int J Urol; 2006 Mar;13(3):294-5
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  • He had undergone right nephroureterectomy for right renal pelvic cancer 9 months previously.
  • There was no sign of recurrent bladder cancer or ureteral cancer.
  • Most of the side-effects of intravesical BCG therapy are minor, and major adverse reactions are rare.
  • Life-threatening ureteral obstruction would be a rare complication of BCG immunotherapy.
  • Although BCG intravesical instillation after nephroureterectomy is a common practice, special care should be taken of renal function in patients with unilateral kidney during BCG therapy.
  • [MeSH-major] Adjuvants, Immunologic / adverse effects. Anuria / chemically induced. BCG Vaccine / adverse effects. Carcinoma, Transitional Cell / drug therapy. Nephrostomy, Percutaneous. Urinary Bladder Neoplasms / drug therapy
  • [MeSH-minor] Administration, Intravesical. Aged. Cystoscopy. Diagnosis, Differential. Follow-Up Studies. Humans. Male. Neoplasm Recurrence, Local / diagnosis. Neoplasm Recurrence, Local / drug therapy. Time Factors. Tomography, X-Ray Computed. Urography

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  • (PMID = 16643629.001).
  • [ISSN] 0919-8172
  • [Journal-full-title] International journal of urology : official journal of the Japanese Urological Association
  • [ISO-abbreviation] Int. J. Urol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Australia
  • [Chemical-registry-number] 0 / Adjuvants, Immunologic; 0 / BCG Vaccine
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