[Results of surgical treatment and postoperative adjuvant chemotherapy of renal pelvic and ureteral cancer].

During the 10-year-and-9-month period from July 1977 to March 1988, 34 cases of renal pelvic and ureteral cancer were surgically treated with total nephroureterectomy combined with partial cystectomy. In cases where the histopathological examination of the surgically excised specimen disclosed a high stage, high grade cancer with vascular tumor invasion, postoperative adjuvant chemotherapy was carried out using cisplatin, cytosine arabinoside and tegafur. Of the 34 cases, 22 are still alive, 7 (20.6%) died of cancer and 5 died of other causes. Histopathologically, all of the 7 patients who died of cancer were found to have grade 3 and stage pT2 or pT3 cancers with intravascular tumor invasion. Cisplatin was used in 13 of the 18 high grade, high stage cases with intravascular tumor invasion. The mortality due to cancer in these 13 cases was 30.8%, while 3 and 5-year survival rates were 69.2% and 51.9%, respectively. In the remaining 5 cases in which cisplatin was not used for postoperative chemotherapy, the mortality due to cancer was 60.0% and the 3 and 5-year survival rates were 53.3% and 26.7%, respectively. Thus, the patients who received postoperative chemotherapy tended to show a better survival rate than those who did not, although the difference in the survival curves between the two groups was not statistically significant. The results from the present study suggest the usefulness of postoperative adjuvant chemotherapy in high stage, high grade renal pelvic and ureteral cancer with intravascular tumor invasion.