Diagnostic Ureteroscopy for Upper Tract Urothelial Carcinoma is Independently Associated with Intravesical Recurrence after Radical Nephroureterectomy
Int. braz. j. urol
;
42(6): 1129-1135, Nov.-Dec. 2016. tab, graf
Article
in English
| LILACS
| ID: biblio-828925
ABSTRACT
ABSTRACT Purpose:
To determine the effect of diagnostic ureteroscopy on intravesical recurrence in patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). Materials andMethods:
We conducted a retrospective analysis of 664 patients who were treated with RNU for UTUC from June 2000 to December 2011, excluding those who had concomitant/prior bladder tumors. Of the 664 patients, 81 underwent diagnostic ureteroscopy (URS). We analyzed the impact of diagnostic ureteroscopy on intravesical recurrence (IVR) using the Kaplan-Meier method. Univariate and multivariate analyses were used to determine the independent risk factors.Results:
The median follow-up time was 48 months (interquartile range (IQR) 31-77 months). Patients who underwent ureteroscopy were more likely to have a small (p<0.01), early-staged (p=0.019), multifocality (p=0.035) and ureteral tumor (p<0.001). IVR occurred in 223 patients during follow-up within a median of 17 months (IQR 7-33). Patients without preoperative ureteroscopy have a statistically significant better 2-year (79.3%±0.02 versus 71.4%±0.02, p<0.001) and 5-year intravesical recurrence-free survival rates (64.9%±0.05 versus 44.3%±0.06, p<0.001) than patients who underwent ureteroscopy. In multivariate analysis, the diagnostic ureteroscopy (p=0.006), multiple tumors (p=0.001), tumor size <3cm (p=0.008), low-grade (p=0.022) and pN0 stage tumor (p=0.045) were independent predictors of IVR.Conclusions:
Diagnostic ureteroscopy is independently associated with intravesical recurrence after radical nephroureterectomy.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Ureteral Neoplasms
/
Urinary Bladder Neoplasms
/
Urologic Neoplasms
/
Ureteroscopy
/
Neoplasm Recurrence, Local
/
Nephrectomy
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
Int. braz. j. urol
Journal subject:
Urology
Year:
2016
Type:
Article
Affiliation country:
China
Institution/Affiliation country:
Peking University First Hospital/CN
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