PROGNOSTIC FACTORS OF UPPER URINARY-TRACT TRANSITIONAL-CELL CARCINOMA (TCC)

In a retrospective study the outcome of 93 patients with TCC of the upper urinary tract was analysed for the relevance of prognostic factors. In addition, a DNA-histogram of the tumors could be established by analysis of paraffin-embedded tissue in 69/93 cases with automated image analysis DNA-cytometry (LEYTAS II SYSTEM). After a mean follow-up period of 33.3 months, 32 (35.5%) patients died of their tumors, therefore the 5- and 10-year survival rate amounted to 54.5% and 34.4%, respectively. Pathological tumor stage (p = 0.0001), grade of malignancy (p = 0.0015) and the DNA-histogram of the tumors (p = 0.0081) showed a significant correlation with prognosis. Furthermore a non-diploid DNA-histogram correlated significantly with invasive tumor growth (p = 0.029), an unfavorable grade of malignancy (p = 0.025) and a tendency towards intraluminal tumor recurrence (p = 0.024). The comparison of different prognostic factors with the use of multivariate analysis revealed pT-stage (p = 0.028) and DNA-histogram (p = 0.0075) as the most important prognostic factors.