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[Efficacy of radiotherapy for upper urinary tract tumor following radical surgery]
A Fernández Rodríguez1, J L Martínez Tores, J F Domínguez Molinero
1Servicio de Urología, Hospital Universitario San Cecilio, Granada, España.
Objective:
To determine the efficacy of postoperative irradiation for locoregional tumor recurrence and in the prevention of distant metastasis in patients with upper urinary tract tumor treated by radical surgery.
Methods:
51 urothelial tumors of the upper urinary tract, most of which had been treated by radical surgery (nephroureterectomy with resection of bladder cuff were analyzed. Since 1989 an adjuvant postoperative radiotherapy protocol (55 Gy) has been included for high grade and stage tumors. Tumor staging was done according to the Jewett-Marshall classification and the Mostoffi cytological grading.
Results:
Of the total number of cases analyzed, 16 received postoperative irradiation; of these, 5 (31%) showed recurrence. The recurrence rate was 47% for those treated by radical surgery alone. In patients with stage C tumors, 5 out of 12 cases (41.6%) showed recurrence. The recurrence rate was higher (83%) for patients with stage C tumors treated by radical surgery alone.
Conclusions:
Adjuvant postoperative radiotherapy is advocated for high grade and stage upper urinary tract tumors. This therapeutic approach has been found to reduce the number of recurrences and, consequently, morbidity. Although the overall survival rate did not increase, a larger series may show more consistent results in this regard.