Hydronephrosis at the diagnosis of bladder cancer is a significant prognostic marker for advanced malignancy, according to German researchers.

George C. Bartsch, MD, and his colleagues at the University of Ulm, studied 788 patients treated with radical cystectomy for transitional cell carcinoma of the bladder without neoadjuvant therapy. Hydronephrosis was present in 133 patients; it was unilateral in 108 patients and bilateral in 25.

The rate of organ-confined tumors was significantly higher in subjects without hydronephrosis (67.9% vs. 37.6%), the researchers reported in European Urology (2007;51:690-698).

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Of the 133 hydronephrosis patients, 43 (32.3%) had a tumor involving the ureteral orifice. In this group, the rate of organ-confined tumors was significantly higher than in the other patients with hydronephrosis (53.5% vs. 30.0%).

Preoperative hydronephrosis, in addition to pT classification and lymph node status, was an independent prognostic marker for recurrence-free survival, according to the investigators.