Abstract
INTRODUCTION: The main problem after Radical Nephroureterectomy (RNU) for localized non-metastatic upper urinary tract urothelial cancer (NM-UUT-UC) is bladder recurrence. AIM: To identify factors of bladder recurrence of localized NM-UUT-UC after radical treatment. METHODS: It is an analytical and observational study that was conducted in the department of urology of La Rabta Hospital in Tunis. We collected the data of patients diagnosed with localized NM-UUT-UC who had RNU between 2005 and 2019. RESULTS: The mean age of the 73 eligible patients was 68 years (±11). The sex ratio was 5/2. Macroscopic hematuria was the revealing clinical sign in 66% of patients, while low back pain was the most frequent sign in 88% of patients. The most frequent tumor stage was pT1 in 20 patients while 32% of them had a pT2-T3 stage. Bladder recurrence was reported in 22% of patients with a median time of nine months [4-27] and extremes of three and 69 months. Factors of bladder recurrence in the univariate analysis were smoking, tumor localization in the ureter and the extravesical excision of the intramural ureter and bladder cuff. On multivariate analysis, the only independent predictor of bladder tumor recurrence was ureteral location (OR=3.65; CI95%=[1.02-13.1] ; p=0.047). CONCLUSION: Tumor localization in the ureter was an independent predictor of bladder recurrence after radical treatment for localized NM-UUT-UC.