[Tumors of the upper urinary tract. Analysis of a series of 85 cases].
الكلمات الدالة
نبذة مختصرة
Case-reports of 85 patients with upper urinary tract tumors were reviewed. Mainly affected were males (87% of cases), particularly over 60 years of age, the principal presenting sign being hematuria. Other signs such as renal colic, lumbago or infections were observed more rarely. The renal pelvis was affected in 52 of the 85 patients (two of these were bilateral), multiple tumor foci being present in only 6 cases. Most tumors were epitheliomas (62 papillary and 13 non-papillary), with 52 of these at the superficial stage (0 or A), 21 at stage B 1 and 5 at stage B II or C. Based on Broders' classification, 48 were grade II and 16 grade III tumors. Prognosis was routinely poor in 5 patients with a stage B or C tumor and lymph node extension. Diagnosis is by intravenous urography, although retrograde ureteropyelography has its place, with increasing interest being given to ultrasound and computed tomography examinations combined with routine cystoscopy. If no particular contraindications exist, the preferred treatment is a total one-stage nephro-ureterectomy without curettage (52 cases), although curettage was performed at the same time in 9 other patients. Conservative surgery has only a limited application: 6 patients had segmental resections of the ureter and 2 patients underwent tumorectomy. Postoperative mortality was particularly loco: 4 patients (4,7%), mainly from vascular or respiratory diseases. (4,7%), mainly from vascular or respiratory diseases. Bone (5 cases), pulmonary (3 cases) and medullary (1 case) metastases represented the main cause of death during the year following surgery, all these patients having infiltrating tumors.(ABSTRACT TRUNCATED AT 250 WORDS)