Clinical and urographic presentation of transitional cell carcinoma of the ureter in a blackfoot disease endemic area in southern Taiwan.

ABSTRACT

We reviewed the clinical, radiographic, and pathologic findings of ureteral transitional cell carcinoma (TCC) in a blackfoot disease (BFD) endemic area in southern Taiwan to increase understanding of tumor behavior in this area, which has a high incidence of urothelium carcinoma. From August 1995 to February 2002, 28 histologically proven ureteral TCCs from this area were eligible for study. There was an unusual female predominance (malefemale ratio, 11.333). The urographic filling defects in the 28 ureteral TCCs were classified into four categories. An ovoid filling defect was significantly associated with non-invasive tumors (p = 0.003) and a trend toward low tumor grades (p = 0.073). The risk of ureteral TCC in this BFD endemic area of southern Taiwan remained high between August 1995 and February 2002. Urographic surveillance provides a simple, clear, inexpensive method to study the extent, location, and morphology of the ureteral mass. Detailed assessment of the image could be useful for preoperative planning and predicting prognosis. Large-scale, randomized, prospective clinical trials are needed to validate our results.