Intravesical Seeding of Upper Urinary Tract Urothelial Carcinoma Cells During Nephroureterectomy: An Exploratory Analysis

Objective: The Pirarubicin Monotherapy Study Group trial was a randomized Phase II study that evaluated the efficacy of intravesical instillation of pirarubicin in the prevention of bladder recurrence after nephroureterectomy for upper urinary tract urothelial carcinoma. This study conducted further analysis of the Pirarubicin Monotherapy Study Group cohort, focusing on intravesical seeding of cancer cells. Methods: Using the data from the Pirarubicin Monotherapy Study Group trial, bladder recur-rence-free survival rates and factors associated with bladder recurrence in the control group were analyzed. Results: Of 36 patients in the control group, 14 with positive urine cytology had more frequent recurrence when compared with the 22 patients with negative cytology (P 0.004). Based on the multivariate analysis in the control group, voided urine cytology was an independent predi-ctive factor of bladder recurrence (hazard ratio, 5.54; 95 % confidence interval 1.12–27.5; P 0.036). Of 72 patients in the Pirarubicin Monotherapy Study Group trial, 31 had positiv