13-Year Survival Comparison of Percutaneous and Open Nephroureterectomy Approaches for Management of Transitional Cell Carcinoma of Renal Collecting System: Equivalent Outcomes

Lee, Benjamin R.; Jabbour, Michel E.; Marshall, Fray F.; Smith, Arthur D.; Jarrett, Thomas W.

doi:10.1089/end.1999.13.289

Cited by 109 publications

(50 citation statements)

References 19 publications

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“…Our 5-year survival rates after conservative management of UUT TCC tumors due to elective indications (75%) confirmed the good outcomes already reported by both endoscopic [19][20][21][22][23] and open organ-sparing procedures [14,[24][25][26][27][28] . Of all UUT, distal ureteral tumors appeared to be the most amenable to conservative treatment [4,8,[11][12][13] .…”

Section: Discussionsupporting

confidence: 83%

Comparison of Open Nephroureterectomy and Open Conservative Management of Upper Urinary Tract Transitional Cell Carcinoma

Dragičević

Djokic

Gazibara³

et al. 2009

Urol Int

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Introduction: The treatment preserving the kidney for upper urinary tract (UUT) transitional cell carcinoma (TCC) is still controversial. We aimed to elucidate the results of open conservative surgery and compare them with the results of radical nephroureterectomy (RNU). Patients and Methods: The study included 107 patients with UUT TCC treated by open conservative surgery (21 patients) or nephroureterectomy (86 patients). Epidemiological, clinical and pathological characteristics of patients as well as 5-year survival rates were compared between groups. Results: Patients treated by conservative surgery had a significantly higher rate of bilateral tumors (38% vs. 3%, p = 0.0001) and smaller tumor size than those treated by radical operations (2.60 ± 1.24 vs. 3.99 ± 3.94 cm, p = 0.060). Five-year survival rates for patients treated by conservative and radical surgery were 59 and 55%, respectively. Within the group of patients treated by conservative surgery, 5-year overall survival rates of patients operated due to imperative and elective indications were 41 and 75%, respectively. In univariate analysis, RNU was a statistically significant predictor of poorer outcome of the disease in comparison with conservative surgery (HR = 2.2, 95% CI 1.1–4.6, p = 0.030). Conclusions: The mode of operation affects the outcome of UUT TCC patients, in addition to factors such as tumor grade, stage and size.

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Section: Discussionsupporting

confidence: 83%

Comparison of Open Nephroureterectomy and Open Conservative Management of Upper Urinary Tract Transitional Cell Carcinoma

Dragičević

Djokic

Gazibara³

et al. 2009

Urol Int

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“…46 Furthermore, Lee and colleagues reviewed their 13-year experience with percutaneous management of upper-tract TCC patients and found no significant difference in overall survival compared with those patients who underwent a nephroureterectomy. 47 Regardless of treatment modality, patients with low-grade lesions did well, while those with high-grade tumors were predisposed to tumor recurrence and progression.…”

Section: Outcomes Following Endourologic Managementmentioning

confidence: 97%

Management of patients with upper urinary tract transitional cell carcinoma

2007

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Multiple therapeutic options are available for the management of patients with upper urinary tract transitional cell carcinoma (TCC). Radical nephroureterectomy with an ipsilateral bladder cuff is the gold-standard therapy for upper-tract cancers. However, less invasive alternatives have a role in the treatment of this disease. Endoscopic management of upper-tract TCC is a reasonable strategy for patients with anatomic or functional solitary kidneys, bilateral upper-tract TCC, baseline renal insufficiency, and significant comorbid diseases. Select patients with a normal contralateral kidney who have small, low-grade lesions might also be candidates for endoscopic ablation. Distal ureterectomy is an option for patients with high-grade, invasive, or bulky tumors of the distal ureter not amenable to endoscopic management. In appropriately selected patients, outcomes following distal ureterectomy are similar to that of radical nephroureterectomy. Bladder cancer is a common occurrence following the management of upper-tract TCC. Currently, there are no variables that consistently predict which patients will develop intravesical recurrences. As such, surveillance with cystoscopy and cytology following surgical management of upper-tract TCC is essential. Extrapolating from data on bladder TCC, both regional lymphadenectomy and neoadjuvant chemotherapy regimens are likely to be beneficial for patients with upper-tract TCC, particularly in the setting of bulky disease.

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“…Percutaneous access allows larger tumors to be resected throughout the collecting system [68,69]. The percutaneous approach is best indicated for patients who have larger renal pelvic tumors, collecting system tumors (greater than 1.5 cm), or bulky proximal ureteral tumors.…”

Section: Percutaneousmentioning

confidence: 99%

“…The percutaneous option is best for grade I or II disease and may be extended beyond patients with solitary kidneys or chronic renal failure [70]. Percutaneous treatment can be offered to healthy individuals with normal contralateral kidneys who are willing to abide by a strict and lengthy follow-up [69].…”

Section: Percutaneousmentioning

confidence: 99%

Minimally Invasive Management of Upper Tract Malignancies: Renal Cell and Transitional Cell Carcinoma

Box

Lehman

Landman

et al. 2008

Urologic Clinics of North America

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13-Year Survival Comparison of Percutaneous and Open Nephroureterectomy Approaches for Management of Transitional Cell Carcinoma of Renal Collecting System: Equivalent Outcomes

Cited by 109 publications

References 19 publications

Comparison of Open Nephroureterectomy and Open Conservative Management of Upper Urinary Tract Transitional Cell Carcinoma

Comparison of Open Nephroureterectomy and Open Conservative Management of Upper Urinary Tract Transitional Cell Carcinoma

Management of patients with upper urinary tract transitional cell carcinoma

Minimally Invasive Management of Upper Tract Malignancies: Renal Cell and Transitional Cell Carcinoma

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