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Significance of cancer involvement at the ureteral margin detected on routine frozen section analysis during radical cystectomy

Cited 15 time in Web of Science Cited 19 time in Scopus
Authors
Lee, Sang Eun; Byun, Seok-Soo; Hong, Sung Kyu; Chang, In Ho; Kim, Yong June; Gill, Myung Chul; Song, Sang Hoon; Kim, Kwang Taek
Issue Date
2006
Publisher
Karger
Citation
Urol Int 2006;77:13-17
Keywords
Bladder cancerRadical cystectomyFrozen section analysisUreteral margin
Abstract
INTRODUCTION: We investigated the clinical significance of preoperatively-unsuspected ureteral involvement of cancer detected on intraoperative frozen section analysis of ureteral margins during radical cystectomy. PATIENTS AND METHODS: We performed a retrospective study of 115 patients who received radical cystectomy for locally-advanced but node-negative transitional cell carcinoma of the bladder between 1995 and 2002 by reviewing their records. RESULTS: Of 115 total patients, 5 (4.3%) demonstrated carcinoma in situ at the ureteral margin with 2 of 5 having a positive margin on final pathologic analysis. Meanwhile, only 3 of 115 total patients (2.6%) later showed upper urinary tract recurrence at a median interval of 30 months after cystectomy. And all 3 patients had intramural or juxtavesical ureter involvement of disease (p = 0.006), while not demonstrating carcinoma in situ in ureteral margins resected during cystectomy. On multivariate analysis, only the stage and grade of bladder cancer along with pathologic feature of vascular invasion were observed to be independent prognostic predictors of disease-specific survival. CONCLUSIONS: Cancer involvement of the distal ureteral margin detected through intraoperative frozen section analysis may not be a significant factor regarding upper tract recurrence and survival of patients with locally-advanced bladder cancer after radical cystectomy. Upper tract recurrence may be more prone to occur in patients with cancer involvement at the intramural or juxtavesical ureter.
ISSN
0042-1138 (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=16825809

http://hdl.handle.net/10371/10571
DOI
https://doi.org/10.1159/000092928
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College of Medicine/School of Medicine (의과대학/대학원)Urology (비뇨기과학전공)Journal Papers (저널논문_비뇨기과학전공)
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