Primary carcinoma of the renal pelvis

Primary carcinoma of the renal pelvis is believed to represent nearly 8% of all malignant renal tumors. The clinical problems of this tumor have been a continuing challenge to early diagnosis and successful therapy. The present experience of 78 cases using the classification of Grabstald showed there is a significantly direct relationship between the tumor stage and the tumor grade. Of these cases, 39.7% manifested bladder malignancy; 38.6% had ureteral tumors. Nephro-ureterectomy with removal of a cuff of bladder as well as frequent followup of cystoscopic examinations continues to offer the best chance of survival. Surprisingly, urine cytology has been, to date, of little value as a screening test because of only slightly better than 30% accuracy. The long-term results using postoperative radiation as well as various chemotherapeutic agents or both are presently not encouraging. Only 10.3% of cases had known occupational exposure to various known carcinogens. Cancer 33:1642–1648, 1974.