SIGNIFICANCE OF URETERAL CARCINOMA IN-SITU IN SPECIMENS OF CYSTECTOMY

In a retrospective review of 242 cystectomy specimens performed for bl adder carcinoma, ureteral carcinoma in situ was found in 14 patients ( 5.7%), unilateral in 12 and bilateral in 2. Pathology of the bladder s pecimen was pT4 (6 cases), pT3 (3 cases), pT2 (1 case), pT1 (3 cases), and pT0 (1 case). In the cystectomy specimen and in previous biopsies , they all had grade 3 tumor, and 85% had bladder CIS. Two patients we re lost during follow-up. Seven patients (58.4%) died of metastatic di sease without evidence of upper tract reccurrence (UTR). Their average survival was 15.8 months (range 4-60). Five patients (41.6%) are aliv e after an average follow-up of 33.6 months (range 18-72 months). In o ne case an UTR appeared 53 months after cystectomy. In patients with u reteral CIS and long-term survival, a careful follow-up is advisable. The incidence of UTR is increased in this subgroup (8% global and 20% of survivors) but mortality is due to progressive bladder disease.