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Urothelial Cancers of the Upper Urinary Tract: Metastatic Pattern and Its Correlation With Tumor Histopathology and Location

Shinagare, Atul B. MD*; Fennessy, Fiona M. MD, PhD*; Ramaiya, Nikhil H. MD*; Jagannathan, Jyothi P. MD*; Taplin, Mary Ellen MD; Van den Abbeele, Annick D. MD*

Journal of Computer Assisted Tomography: March-April 2011 - Volume 35 - Issue 2 - p 217-222
doi: 10.1097/RCT.0b013e31820d7a37
Abdominal Imaging

Objective: To study the metastatic pattern of upper urinary tract urothelial cancer and to correlate it with tumor histopathology and location.

Methods: After approval by the institutional review board, we studied patients with pathologically proven metastatic urothelial cancers of renal pelvis or ureter, who presented between January 2003 and December 2009. The metastasis-free interval and metastatic pattern were compared for T stage, histopathological subtype (transitional cell carcinoma versus atypical histology), and location (renal pelvis versus ureter).

Results: The study group consisted of 52 patients (33 men and 19 women: transitional cell carcinoma, 69% [36/52]; atypical histology, 31% [16/52]; renal pelvis, 73% [38/52]; ureter, 27% [14/52]). Lymph nodes (75% [39/52]), lung (65% [34/52]), liver (54% [28/52]), bone (39% [20/52]), and peritoneum (19% [10/52]) were the most common metastatic sites. There was no difference in the metastatic pattern for different T stages, histologic groups, or locations.

Conclusion: Lymph nodes, lung, liver, bone, and peritoneum are the most common metastatic sites of upper urinary tract urothelial cancers. Tumor histology and location within the upper urinary tract have no effect on metastatic pattern.

From the *Department of Imaging, Dana-Farber Cancer Institute; Department of Radiology, Brigham and Women's Hospital; and †Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.

Received for publication August 18, 2010; accepted December 28, 2010.

Reprints: Atul B. Shinagare, MD, Department of Imaging, Dana-Farber Cancer Institute, 44 Binney St, Boston, MA 02115 (e-mail:;

© 2011 Lippincott Williams & Wilkins, Inc.