Bretheau D, Lechevallier E, Jean F, Rampal M, Coulange C
Service d'Urologie, Hôpital de la Timone, Marseille.
Prog Urol. 1993 Dec;3(6):979-87.
In a series of 107 patients treated over an 11-year period for upper urinary tract tumours (UTT), 30 had a synchronous or metachronous associated bladder tumour. The bladder tumour preceded the UTT in 10.3% of cases, the bladder tumour was synchronous in 6.5% of cases and the bladder tumour occurred after the UTT in 15% of cases, the incidence of UTT after cystectomy over this 11-year period was 3.3%. The median time to recurrence of the UTT after bladder tumour was 17 months. The median time to recurrence of the bladder tumour after the UTT was 12 months. The risk of bladder recurrence after treatment of the upper tract tumour was studied in relation to site, type of treatment, multifocal nature, stage and grade of the UTT and the presence of a previous or synchronous associated bladder tumour. None of these parameters constituted a predictive factor of bladder recurrence after treatment of an upper tract tumour. Comparison of survival between the UTT + bladder tumour group and the UTT alone group did not reveal any significant difference (p = 0.10). The theory of cellular implantation facilitated by vesicorenal reflux and the multifocal theory are complementary explanations of the multifocal and recurrent nature of urothelial tumours.
在11年期间接受治疗的107例上尿路肿瘤（UTT）患者中，30例有同步或异时性相关膀胱肿瘤。膀胱肿瘤在10.3%的病例中先于UTT出现，在6.5%的病例中与UTT同步出现，在15%的病例中在UTT之后出现，在这11年期间膀胱切除术后UTT的发生率为3.3%。膀胱肿瘤出现后UTT复发的中位时间为17个月。UTT出现后膀胱肿瘤复发的中位时间为12个月。研究了上尿路肿瘤治疗后膀胱复发的风险与UTT的部位、治疗类型、多灶性、分期和分级以及既往或同步相关膀胱肿瘤的存在情况之间的关系。这些参数均未构成上尿路肿瘤治疗后膀胱复发的预测因素。UTT + 膀胱肿瘤组与单纯UTT组的生存率比较未显示任何显著差异（p = 0.10）。由膀胱肾反流促进的细胞种植理论和多灶性理论是尿路上皮肿瘤多灶性和复发性的互补解释。
