1. [Value of postoperative radiotherapy in malignant tumors of the upper urinary tract. Apropos of a series of 26 patients].
- Author
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Maulard-Durdux C, Méjean A, Dufour B, Hennequin C, Chrétien Y, Vignes B, Droz D, Delanian S, and Housset M
- Subjects
- Adult, Aged, Carcinoma, Transitional Cell mortality, Carcinoma, Transitional Cell pathology, Carcinoma, Transitional Cell surgery, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasm Metastasis, Neoplasm Staging, Prognosis, Radiotherapy Dosage, Radiotherapy, Adjuvant, Retrospective Studies, Survival Rate, Ureteral Neoplasms mortality, Ureteral Neoplasms pathology, Ureteral Neoplasms surgery, Carcinoma, Transitional Cell radiotherapy, Ureteral Neoplasms radiotherapy
- Abstract
To evaluate the role of adjuvant radiation therapy in invasive transitional cell carcinoma of the upper urinary tract, we retrospectively reviewed a series of 26 patients who underwent radical surgery plus post-operative prophylactic irradiation for such a tumor. Between 1980 and October 1993, 18 men and eight women (mean age: 65 +/- 9 years) were treated for an invasive transitional cell carcinoma of the upper urinary tract. Tumor location was the renal pelvis in 15 patients (58%). The tumor was pathological stage B in 11 patients (42%) and stage C in 15 patients (58%). Tumor grade was 2 in ten patients, 3 in 15 and unknown in one. Nine patients had node involvement. All patients underwent surgery followed by radiation therapy to a total dose of 45 Gy to the tumor bed (23 patients) and/or regional nodes (18 patients). After a mean follow-up of 45 months, 13 patients (50%) were alive and 11 were disease-free. Local tumor relapse, nodal recurrence, metastasis and second urothelial location were noted in one, four (15%), 14 (54%) and eight patients (30%) respectively. Overall 5-year survival and 5-year disease-free survival were 49% and 30% respectively. Overall 5-year survival rates were 60% for stage B and 19% for stage C disease (P = 0.07), 43% for node-negative versus 15% for node-positive cancer (P = 0.04) and 90% for grade 2 and 0% for grade 3 tumors (P < 0.01). In this study using a radio-surgical approach, local control of disease and survival were similar to those reported previously in surgical series. Prophylactic post-operative radiation therapy is not recommended. more...
- Published
- 1996