The Korean Journal of Urological Oncology 2008;6(2):87-91.
Published online August 30, 2008.
신우 요로상피세포암에서 신실질 침범의 예후적 의의
정재일, 오승엽, 윤장호, 정세일
인제대학교 의과대학 비뇨기과학교실, 1동아대학교 의과대학 비뇨기과학교실
Prognostic Impact of Renal Parenchymal Invasion of Urothelial Carcinoma of Renal Pelvis
Jae-il Chung , Seung Yeub Oh , Jang Ho Yoon , Seil Jung
Department of Urology, College of Medicine, Inje University and
Correspondence:  Seil Jung
Abstract
Purpose: Pathologic pT3 urothelial carcinoma of renal pelvis exhibits various patterns of invasion, such as peripelvic fat invasion or renal parenchymal invasion. We evaluated the prognostic impact of renal parenchymal invasion of urothelial carcinoma of renal pelvis. Materials and Methods: Of 42 patients who underwent nephroureterectomy with bladder cuff excision for renal pelvis urothelial carcinoma, 23 patients with pT3 were evaluated. We retrospectively investigated prognostic factors such as stage, gender, laterality, renal parenchymal invasion, peripelvic fat infiltration, involvement of lymph nodes, and grade. Especially in pT3 tumors, pathological reports and imaging studies were reviewed elaborately. Invasion patterns were classified as peripelvic fat invasion and renal parenchymal invasion. Each factors were analyzed with respect to survival rate using univariate log-rank test, Kaplan-Meier survival curve. Results: The average follow-up period was 30.9 months. Two-year survival rates of each group were 100%, 65.9% and 33.3%. And 5-year survival rates were 87.5%, 45.2% and 0%. Out of 23 cases of pT3, 14 cases had renal parenchymal invasion and 9 had peripelvic fat infiltration. In pT3 group, there was no significant difference in survival rate between renal parenchymal invasion group and peripelvic infiltration group. Conclusions: T stage was the most important prognostic factor in renal pelvis tumor as other urothelial carcinoma. Although the survival curves of pT3 showed no significant difference between renal parenchymal invasion and peripelvic fat infiltration, there was poor survival pattern in parenchymal invasion. Therefore, we need more clinical cases and long term follow-up. (Korean J Urol Oncol 2008;6:87-91)
Key Words: Urothelial carcinoma, Kidney pelvis, Prognosis


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