Metastasis of cancers of the kidney calyx, the ureter and the bladder
Schneider, M.
Annales d'Urologie 25(6-7): 284-290
1991
ISSN/ISBN: 0003-4401 PMID: 1793253 Document Number: 378470
Cancers of the renal pelvis, the ureter and the bladder are often accompanied by bone, lung and liver metastases. The frequency of metastases, which may occur early during the course of the disease, is directly correlated with the stage. The metastatic potential can be partially evaluated using certain prognostic factors: local extent of lesions, cytogenetic abnormalities, oncogenes and suppressor oncogenes, factors secreted by the tumor, proliferative activity. Chemotherapy produces an overall response in 50-75% of patients, 10-15% of whom achieve a long term response. Several agents are active, particularly cisplatinum and methotrexate; in addition, combination regimens (especially M-VAC) have proven more effective than single agents used alone. Neo-adjuvant chemotherapy administered prior to local treatments given encouraging results, as does adjuvant chemotherapy. However, additional investigations are still required to evaluate the exact role of chemotherapy in the therapeutic strategy for these para-malpighian cancers.