| Objective To improve the diagnosis and treatment of primary ureteral cancer.Methods A retrospective analysis of diagnosis,treatment and prognosis of 32 cases of primary ureteral cancer which was in the First Affiliated Hospital from 2004 to 2007.Results Between 2004 and 2007 32 patients underwent primary ureteral cancer in our department.The patients consisted of 19 males and 13 females.The range of age was 44 to 90,the history of disease was 1 week to 2 years.All cases were confirmed ultrasound,of which 5 cases were examined tumor in ureter and 23 cases were examined hydronephrosis.16 cases were confirmed intravenous pyelography,of which 8 cases did not develop images in involved kidney and ureter,and 7 cases developed images of filling defect in ureteral lumens.11 cases were confirmed retrograde pyelograph,of which 6 cases developed images of filling defect or stricture in ureteral lumens.19 cases were confirmed CT,of which 15 cases were detected tumors of soft tissue in lumens.6 cases were confirmed MRU,all of which developed images of interrupting obstruction in ureteral lumens.In 15 cases of receiving examination of exfoliocytology,4 cases expressed positive.Examination of cystoscope were given to 28 cases,of which 6 cases were detected neoplasm in ureteric orifice,and 17 cases were detected jetting blood in ureteric orifice.Examination of ureteroscope was given to 3 patients,of which 3 patients were detected tumor in ureter,and later the tumors were all confirmed transitional cell carcinoma by pathological examination.All cases recepted operation.27 cases were given operation of cutting the involved kidney,total length ureter,and urinary bladder like cuffs,1 case was given operation of cutting inferior part of ureter and part urinary bladder and transplantation of ureter and urinary bladder,and 1 case was given operation of cutting the total length ureter,part of the bladder and nephrostomy.32 cases proved to be transitional cell carcinoma by pathological section after operation,of which 3 cases wereâ… stage,18 cases wereâ…¡stage,9 case wereâ…¢stage,2 cases wereâ…£stage;6 cases were G1-2,19 cases were G2-3,7 cases were over G3.26 cases had been followed-up for 6 to 42 months.3 patients died within 3 years,of which 1 patient died of relapse of tumor,and the cancer was high stage and high grade.2 patients died of accidents.23 patients were still alive,in which 10 patients were still alive after 3 years,who were given operation of cutting the involved kidney,total length ureter,and urinary bladder like cuffs.Conclusion The diagnose of primary ureteral cancer should combine the history with ultrasound,CT,MRI,cystoscope,and ureteroscope to improve the diagnose.Primary ureteral cancer is mainly treated with operation,which is usually cutting the involved kidney,total length ureter,and urinary bladder like cuffs.But as to patients who are not fit to receive the classic operation style such as solitary kidney,renal inadequacy in the opposite kidney,intolerant to operation or tumors of upper urinary tract exist in both sides,conservative operation of reserving kidney can be used,and follow-up should be strengthened. |
