Multifactor analysis of prognosis and the incidence of secondary bladder cancer in patients with primary ureteral carcinoma

Abstract:

Objective：To discuss the risk factors which influence prognosis and the incidence of secondary bladder cancer in patients with primary ureteral carcinoma. Methods：The clinical data of 58 patients were retrospectively analyzed. All patients were pathologi－cally diagnosed with primary ureteral carcinoma in the First Affiliated Hospital of Chongqing Medical University from June，2010 to September，2017 and then treated by operation. Clinical and pathological factors，seven on prognosis and five on the incidence of sec－ondary bladder cancer，were collected and analyzed with univariate analysis and multivariate analysis respectively. Results：Univariate analysis identified three factors that were associated with prognosis：clinical stage（ χ2=16.441，P=0.000），histological grade of tumor （ χ2=6.941，P=0.008），chemotherapy or not（ χ2=4.934，P=0.026）. But age（ χ2=2.013，P=0.156），gender（ χ2=0.414，P=0.520），method of operation（ χ2=6.565，P=0.010） and multifocal or unifocal tumor（ χ2=0.128，P=0.720） showed no significant influence on prognosis. The depth of invasion（ χ2=5.314，P=0.021），bladder irrigation after operation（ χ2=3.919，P=0.048），histological grade of tumor（ χ2=7.025，P=0.008） and method of operation（ χ2=6.565，P=0.010） were significantly associated with the incidence of secondary bladder cancer. But multifocal or unifocal tumor（ χ2=0.336，P=0.562） had no statistical significance on the incidence of secondary bladder cancer. Multi－variate analysis identified the significant factors for prognosis of ureteral cancer were clinical stage（RR=6.037，95%CI=1.708 to 21.333，P=0.005） and histological grade of tumor（RR=10.032，95%CI=1.161 to 86.695，P=0.036）. The influencing factors on the incidence of secondary bladder cancer were high grade histological of tumor（RR=8.942，95%CI=1.175 to 68.056，P=0.034） and non radical operation（RR=3.819，95%CI=1.424 to 10.244，P=0.008）. Conclusion：The significant factors for prognosis of ureteral cancer are clinical stage and histological grade of tumor. The significant influencing factors on the incidence of secondary bladder cancer after ureteral cancer are the method of operation and histological grade of tumor.