Upper-tract tumors after an initial diagnosis of bladder cancer: Argument for long-term surveillance Journal Article
| Authors: | Rabbani, F.; Perrotti, M.; Russo, P.; Herr, H. W. |
| Article Title: | Upper-tract tumors after an initial diagnosis of bladder cancer: Argument for long-term surveillance |
| Abstract: | Purpose: To determine the relative risk (RR) of upper-tract tumors (UTT) after bladder cancer, stratified by bladder tumor characteristics, demographic factors, and follow-up duration, in order to develop an improved risk-based surveillance strategy. Patients and Methods: The 1973 to 1996 Surveillance, Epidemiology, and End Results (SEER) database was used to determine the observed and expected number of UTT after bladder cancer. The RR with 95% confidence intervals (CI) were calculated, stratifying by race, sex, stage, grade, histology, and follow-up duration. The tumor characteristics and clinical outcome were compared in patients with UTT after bladder cancer and those with de novo UTT. Results: A total of 94,591 patients had a first diagnosis of bladder cancer, of whom 91,245 had follow-up (median, 4.1 years), with no antecedent or synchronous UTT. UTT developed subsequently in 657 of 91,245 (0.7%), with 12.80 expected cases (RR = 51.3; 95% Cl, 47.5 to 55.4). The respective RRs for UTT for white men and women were 64.2 (95% Cl, 55.1 to 74.3) and 75.4 (95% Cl, 57.7 to 96.9) at less than 2 years, 44.3 (95% Cl, 36.7 to 53.0) and 40.5 (95% Cl, 27.9 to 56.8) at 2 to 5 years, 50.8 (95% Cl, 42.2 to 60.7) and 42.1 (95% Cl, 28.8 to 59.4) at 5 to 10 years, and 43.2 (95% Cl, 32.6 to 56.1) and 22.2 (95% Cl, 10.1 to 42.2) at ≥ 10 years. Similar RRs were seen among different strata of race, stage, grade, and histology. Patients with UTT after bladder cancer had lower stage and improved disease-specific survival compared with those with de novo UTT. Conclusion: The incidence of UTT is stable on long-term follow-up, with no significant risk factors identified. These findings suggest that upper-tract surveillance remain rigorous on extended follow-up of bladder cancer patients. © 2001 by American Society of Clinical Oncology. |
| Keywords: | adolescent; adult; cancer survival; child; aged; aged, 80 and over; child, preschool; middle aged; survival rate; major clinical study; histopathology; united states; cancer staging; follow up; cancer grading; demography; neoplasm recurrence, local; proportional hazards models; incidence; data base; bladder cancer; risk factor; urinary bladder neoplasms; sex ratio; risk; urologic neoplasms; infant; infant, newborn; cancer epidemiology; neoplasms, second primary; analysis of variance; race difference; humans; human; male; female; priority journal; article |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 19 |
| Issue: | 1 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2001-01-01 |
| Start Page: | 94 |
| End Page: | 100 |
| Language: | English |
| PUBMED: | 11134200 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 21 May 2015 -- Source: Scopus |
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