[Tumors Following Urinary Diversions. Results of a Multicenter Study]

Overview

Journal Urologe A

Specialty Urology

Date 2011 May 12

PMID 21559915

Authors

T Kalble

I Hofmann

Affiliations

Soon will be listed here.

Abstract

Background: The risk estimation of secondary tumors after different types of urinary diversion with intestinal segments has as yet been possible only for ureterosigmoidostomy.

Method: We analyzed the operative records of 44 German clinics for urinary diversions performed from 1970 to 2007 and registered all reported secondary tumors up to 2009.

Results: In 17,758 urinary diversions 32 secondary tumors occurred. The tumor risk in ureterosigmoidostomy (2.58%) and cystoplasty (1.58%) is significantly higher than in other continent forms of urinary diversion (p<0.0001). The risk in orthotopic (ileo)colonic neobladders (1.29%) is significantly higher (p=0.0001) than in ileal neobladders (0.05%). The difference between ileocecal pouches (0.14%) and ileal neobladders is not significant (p=0.46).

Conclusion: Ureterosigmoidostomies, cystoplasties, and orthotopic (ileo)colonic neobladders necessitate regular endoscopic evaluation from at least the fifth postoperative year. After ileal neobladders, conduits, and catheterizable ileocecal pouches regular routine endoscopy is not imperative.

References

GENNARO A, Villanueva R, Sukonthaman Y, Vathanophas V, ROSEMOND G . Chemical carcinogenesis in transposed intestinal segments. Cancer Res. 1973; 33(3):536-41. View

Gobet R, Weber D, Renzulli P, Kellenberger C . Long-term follow up (37-69 years) of patients with bladder exstrophy treated with ureterosigmoidostomy: uro-nephrological outcome. J Pediatr Urol. 2009; 5(3):190-6. DOI: 10.1016/j.jpurol.2008.11.007. View

Wielding S, Fineron P, Driscoll P, Anderson D . Late malignant change in an ileal conduit. Int J Urol. 2008; 15(1):99-101. DOI: 10.1111/j.1442-2042.2007.01930.x. View

Han S, Starling J, Jarrard D . Indiana pouch urinary diversion for adenocarcinoma developing after ureterosigmoidostomy. J Urol. 2001; 166(4):1391-2. View

Austen M, Kalble T . Secondary malignancies in different forms of urinary diversion using isolated gut. J Urol. 2004; 172(3):831-8. DOI: 10.1097/01.ju.0000134890.07434.8e. View

Ali-El-Dein B, El-Tabey N, Abdel-Latif M, Abdel-Rahim M, El-Bahnasawy M . Late uro-ileal cancer after incorporation of ileum into the urinary tract. J Urol. 2001; 167(1):84-8. View

North A, Lakshmanan Y . Malignancy associated with the use of intestinal segments in the urinary tract. Urol Oncol. 2007; 25(2):165-7. DOI: 10.1016/j.urolonc.2006.09.008. View

Pickard R . Tumour formation within intestinal segments transposed to the urinary tract. World J Urol. 2004; 22(3):227-34. DOI: 10.1007/s00345-004-0438-4. View

Kalble T, Busse K, Amelung F, Waldherr R, Berger M, Edler L . Tumor induction and prophylaxis following different forms of intestinal urinary diversion in a rat model. Urol Res. 1995; 23(6):365-70. DOI: 10.1007/BF00698735. View

10.

Yamada Y, Fujimura T, Takahashi S, Takeuchi T, Takazawa Y, Kitamura T . Tubulovillous adenoma developing after urinary reconstruction using ileal segments. Int J Urol. 2006; 13(8):1134-5. DOI: 10.1111/j.1442-2042.2006.01506.x. View

11.

Lavelle J, Shenot P, Smith C, Chancellor M . Re: secondary malignancies in different forms of urinary diversion using isolated gut. J Urol. 2005; 173(5):1831. DOI: 10.1097/00005392-200505000-00158. View

12.

Williamson R, DAVIES P, Bristol J, Wells M . Intestinal adaptation and experimental carcinogenesis after partial colectomy. Increased tumour yields are confined to the anastomosis. Gut. 1982; 23(4):316-25. PMC: 1419731. DOI: 10.1136/gut.23.4.316. View

13.

Tollefson M, Elliott D, Zincke H, Frank I . Long-term outcome of ureterosigmoidostomy: an analysis of patients with >10 years of follow-up. BJU Int. 2009; 105(6):860-3. DOI: 10.1111/j.1464-410X.2009.08811.x. View

14.

Kalble T, Tricker A, Friedl P, Waldherr R, Hoang J, Staehler G . Ureterosigmoidostomy: long-term results, risk of carcinoma and etiological factors for carcinogenesis. J Urol. 1990; 144(5):1110-4. DOI: 10.1016/s0022-5347(17)39670-2. View

15.

Smeulders N, Sudhakaran N, Wilcox D, Ransley P . Adenocarcinoma at the ureterosigmoidostomy site in a 16-year-old demonstrates the importance of screening in children. J Pediatr Urol. 2008; 4(3):234-5. DOI: 10.1016/j.jpurol.2007.10.004. View

16.

Soergel T, Cain M, Misseri R, Gardner T, Koch M, Rink R . Transitional cell carcinoma of the bladder following augmentation cystoplasty for the neuropathic bladder. J Urol. 2004; 172(4 Pt 2):1649-51. DOI: 10.1097/01.ju.0000140194.87974.56. View

17.

Berberian J, Goeman L, Allory Y, Abbou C, Salomon L . Adenocarcinoma of ileal neobladder 20 years after cystectomy. Urology. 2006; 68(6):1343.e9-10. DOI: 10.1016/j.urology.2006.09.014. View