[Prognostic factors in tumors of the upper urinary tract]

Review of patients treated for tumours of the upper urinary tract (UUTT) in our hospital during the 1969-1992 period. The characteristics studied were: stage (TNM 1987), grade (OMS), associated vesical tumour, location of primitive tumour, size, number, surgery performed and presence of tumoral relapse. Cox's regression model was used for the analysis of prognostic factors with survival time as the response variable. The sample has 92 patients (78% men and 22% women), average age 64 years. The tumours were: 46 pyelitic, 36 ureteral and 10 mixed. Stage distribution was: 13 pTa (14%), 41 pT1 (45%), 16 pT2 (17%), 15 pT3 (17%), 3 pT4 (7%); grade distribution: 22 grade I (24%), 54 grade II (59%) and 16 grade III (17%) 48% cases presented associated vesical tumour and 15% relapsed. The sample's median survival was 81 months and survival probability at 5 and 10 years was 52% and 45%. A significant association with survival time was shown by: stage, grade, sex and renal annulment. The multivariant analysis selected: 1) stage; 2) renal annulment and 3) sex. The predictive power of staging is indisputable, thus becoming the first selected variable. Renal annulment and sex factors add independent information on evolution. The information provided by the tumour's grade highly correlates to that of the stage, and therefore it was not selected in the multivariant analysis.