Bladder tumors: Association with upper tract neoplasms

Following treatment for urothelial carcinoma of the bladder (UCB), patients are at risk for urothelial recurrence in the bladder, urethra and upper tracts. This may be due to a field effect in the urothelium or implantation of malignant cells shed from the primary tumor [1]. Conversely, following treatment for upper tract urothelial carcinomas (UTUC) there is a 13-54 % and 6 % risk of recurrence in the bladder and contralateral upper tract, respectively [2]. Theoretical causes for intravesical recurrence following treatment for UTUC include tumor cell shedding during surgery, angiogenic factors released into the bladder as a consequence of the bladder incision, and a compromised immune status due to surgery [3]. Because there is a risk of UTUC after treatment for UCB, and UCB after treatment for UTUC, long-term surveillance of the urothelium is necessary in patients with a history of urothelial carcinoma.