Primary Grade 1 Transitional Cell Carcinoma of the Renal Pelvis and Ureter

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Abstract
During a 22 yr period, 224 patients were treated for transitional cell carcinoma of the renal pelvis or ureter. Of these patients, 49 (22%) had grade 1 lesions. Follow-up ranged from 5-25 yr. The most common symptom was hematuria. In 54% of the 49 patients was a filling defect noted on excretory urography. Patients (47, 96%) had stage I disease. Treatment included total nephroureterectomy, nephrectomy or segmental resection. In 11 patients (23%) evidence of bladder tumor developed 8 mo. to 12 yr (average 4 yr) after the diagnosis of tumor of the upper urinary tract; 73% of these recurrences were noted within the first 3 yr. In 1 patient a tumor developed in the opposite upper urinary tract. In 1 of 15 patients who had partial ureterectomy or local excision, tumor developed in the ipsilateral ureter. Patient survival time was identical to that in an age-matched control group. The most significant findings are the subsequent high incidence (23%) of bladder tumor and the comparable survival in these patients and in an age-matched control group. Operations preserving the renal parenchyma, i.e., segmental resection, probably should be used more frequently.