The clinical significance of hydronephrosis and the tumor diameter in ureteral transitional cell carcinoma

Purpose: We evaluated the clinical significance of the grade of hydronephrosis and the tumor diameter in ureteral transitional cell carcinoma (TCCa). Materials and methods: From 1986 to 2003, the medical records of 101 patients who had been surgically treated and diagnosed with ureteral TCCa were retrospectively reviewed with regard to the clinicopathological characteristics, including the grade of hydronephrosis and the tumor diameter. Results: The grade of hydronephrosis was grade 0 in 11 patients, grade I/II in 34 patients and grade III/IV in 56 patients, respectively. The tumor diameter measured on the transverse section of computed tomography was <1.5cm in 39 patients, 1.5cm ≤ <2.5cm in 36 patients and ≥2.5cm in 26 patients, respectively. Of the 56 patients with grade III/IV hydronephrosis, invasive tumor was found in 49 patients (87.5%) and grade III tumor was found in 48 patients (85.7%). Of the 62 patients with a tumor diameter 1.5cm or greater, invasive tumor was found in 50 patients (80.6%) and grade III tumor was found in 52 patients (83.9%). The grade of hydronephrosis and the tumor diameter correlated with the T stage and tumor grade (p < 0.001). In addition, the grade of hydronephrosis (p=0.041) and the tumor diameter (p=0.007) have a significant influence on the disease-specific survival. Conclusions: The grade of hydronephrosis and the tumor diameter correlate with the pathologic T stage and tumor grade. Thus, radical surgery is required for the patients with severe hydronephrosis or a large tumor diameter.