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Registration of renal pelvic and ureteral tumor was done from 1980 through 1986, in the Tokai Urological Tumor Registry. Among the 404 cases of the carcinoma, 384 cases (210 renal pelvis, 174 ureter) were subjected to the present study. A total of 319 cases (83.1%) showed a complete cure, while 20 cases (5.2%) were considered as partial cure, and 45 cases (11.7%) were classified to progressive disease group. Chemotherapy was performed on 151 patients including systemic administration to 141 patients (33.9%) and 11 patients received combined intravesical instillation therapy. Irradiation was performed on 49 patients (12.8%). Degree of histological and morphological differentiation of renal pelvis and ureter tumor were studied in 341 cases of transitional cell carcinoma (88.8%); G0, 0.3%, G1, 12.9%, G2, 49.3%, Gx, 5.2%. Stage of the tumor were T1, 33.6%; T2, 12.5%; T3, 14.6%; T4, 13.3%; Tis, 0.3%; Tx, 24.7%. Five-year relative survival for carcinoma of the renal pelvis was 46.6%, and for the ureter it was 53.1%. Five-year survival according to histological differentiation of transitional cell carcinoma and according to the stage of the tumor were as follows; G1, 91.6%; G2, 58.5%; G3, 27.2%; Ta, 84.6%; T1. 74.2%; T2, 48.5%; T3, 24.1%, T4, 7.3%. The rate of survival was correlated with histological differentiation of the tumor cells. The survival was poor in cases who had the components of squamous cell carcinoma and/or adenocarcinoma. Overall survived case were 177, 122 patients died of cancer, 20 patients died of other causes than cancer, and 1 patient died from immediate surgical effect.(ABSTRACT TRUNCATED AT 250 WORDS)

As neoadjuvant chemotherapy for advanced bladder cancer, the intra-arterial administration of methotrexate (MTX), Adriamycin (ADM), and cisplatin (CDDP; IA-MAC) was evaluated. A total of 48 patients with bladder cancer (greater than or equal to T2 or CIS) were selected and received 30.1 mg MTX, 34.5 mg ADM, and 89.1 mg CDDP as an average course. The mean tumor-regression rate after 2 or 3 weeks was 52.3%, and patients with grade 3 transitional-cell carcinoma showed the best results, achieving a 69.6% regression rate. In 30 cases (63%), downstaging was observed. Among the 46 patients who underwent subsequent surgical therapy, the bladder could be preserved in 26 cases by transurethral resection or segmental resection. According to the criteria of the Japanese Association of Cancer Therapy, a histological effect of GIII or better was obtained in 15 cases (29%). The histological effect correlated well with the tumor-regression rate. As compared with intravenous therapy with MTX, vinblastine, ADM, and CDDP (M-VAC), IA-MAC treatment was well tolerated due to its lower degree of bone marrow suppression, and it resulted in a longer disease-free interval and better survival. In addition, the period prior to surgical therapy was shortened in this study. These results suggest that IA-MAC chemotherapy can be useful as an arm of multidisciplinary treatment of advanced bladder tumors.