Current Practice Patterns in Urologic Management of Upper-Tract Transitional-Cell Carcinoma

Razdan, Sanjay; Johannes, James; Cox, Michael R.; Bagley, Demetrius H.

doi:10.1089/end.2005.19.366

Cited by 29 publications

(13 citation statements)

References 54 publications

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“…The present report offers considerable insight into current practice patterns surrounding NU surgery within the UK in 2012, and the results compare favourably with those reported from other large international series [3][4][5][6][7][8][9]. It is thought that the data for nephrectomy surgery gathered by the BAUS encompasses >80% of all such surgery performed in the UK in 2012, representing a substantial strength of the present publication.…”

Section: Discussionsupporting

confidence: 74%

Nephroureterectomy surgery in the UK in 2012: British Association of Urological Surgeons (BAUS) Registry data

Connolly

Rochester

Baus³

2015

BJU Int

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Registry data entered by each individual surgeon's team (self-reported) on all 6042 nephrectomy surgeries reported to BAUS during 2012 were analysed to identify all NU surgery. Parameters for analysis included demographics, indication, type of surgery, histopathology and complications (Clavien system) of surgery. Data did not include tumour location or multiplicity, preoperative diagnostic evaluation or details of minimally invasive surgery (MIS) undertaken. Before analysis for this report a central process of 'datacleansing' was undertaken by a BAUS group to address any discrepancy between the listed surgery and the preoperative indication. ResultsIn all, 863 NU surgeries were included, performed by 220 consultant surgeons in 119 centres, and the median (range) number of NU per surgeon and unit was 3 (1-20) and 6 (1-29), respectively. The most common age group was 71-80 years (40%), most were male (64%), and haematuria was the most common presentation (74%). The dominant pathology was upper tract urothelial cancer (89%, 735), with final stage ≥pT2 in 47% (367), and the grade was 1, 2 or 3 in 6% (38), 36% (228) and 58% (362) respectively. Operative technique included MIS in 85% (720) and total reported operative complication rate (any Clavien) was 15% (128), of which Clavien ≥3 was reported in 4% (36), and perioperative death was reported in nine patients (1%). Advantages in favour of MIS included reduced hospital stay (median 5 vs 8 days), reduced major blood loss (3% vs 14%) and reduced transfusion requirement (6% vs 24%). In all, 76 cases (8%) were excluded from analysis based on benign pathology leading to reassignment to the 'simple nephrectomy' category. ConclusionsNU is currently a low-volume operation (median 3 cases/ year) within the remit of the nephrectomy surgeon, but is a safe procedure with a relatively low complication rate. Most NU surgery in the UK is now performed with laparoscopic assistance, with advantages including reduced major blood loss, reduced transfusion requirement and shorter hospital stay.

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Section: Discussionsupporting

confidence: 74%

Nephroureterectomy surgery in the UK in 2012: British Association of Urological Surgeons (BAUS) Registry data

Connolly

Rochester

Baus³

2015

BJU Int

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“…[2][3][4][5][6] Whilst advances in flexible fibre-optic instruments and improvements in laser technology have made organsparing endoscopic management of low-grade TCC a realistic option in high-grade or multifocal disease, based on principles of surgical oncology, nephroureterectomy remains the preferred management option.Until fairly recently, nephroureterectomy was performed based on pre-operative imaging such as intravenous urography (IVU), CT, retrograde pyelography (RGP) and abnormal selective urine cytology. With advances in instrument technology and the regular use of flexible ureteroscopy for .…”

mentioning

confidence: 99%

“…1 In recent years, laparoscopic nephroureterectomy with open excision of the lower ureter is replacing this procedure as the new gold standard. [2][3][4][5][6] Whilst advances in flexible fibre-optic instruments and improvements in laser technology have made organsparing endoscopic management of low-grade TCC a realistic option in high-grade or multifocal disease, based on principles of surgical oncology, nephroureterectomy remains the preferred management option.…”

mentioning

confidence: 99%

Nephroureterectomy for Transitional Cell Carcinoma – The Value of Pre-Operative Histology

Chitale

Mbakada

Irving

et al. 2008

annals

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In recent years, laparoscopic nephroureterectomy with open excision of the lower ureter is replacing this procedure as the new gold standard. [2][3][4][5][6] Whilst advances in flexible fibre-optic instruments and improvements in laser technology have made organsparing endoscopic management of low-grade TCC a realistic option in high-grade or multifocal disease, based on principles of surgical oncology, nephroureterectomy remains the preferred management option.Until fairly recently, nephroureterectomy was performed based on pre-operative imaging such as intravenous urography (IVU), CT, retrograde pyelography (RGP) and abnormal selective urine cytology. With advances in instrument technology and the regular use of flexible ureteroscopy for . Increasing use of diagnostic upper tract endoscopy has underlined the importance of obtaining a pre-operative histological diagnosis in order to avoid under-treating high-grade or multifocal disease and over-treating low-grade disease, which could, in selected cases, be managed conservatively. We review nephroureterectomy at our institution over a 10-year period with particular reference to a pre-operative histological diagnosis.

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“…Bagley and colleagues sent a survey to members of the Society of Urologic Oncology, Endourological Society, and American Urological Association regarding treatment and surveillance strategies for upper tract tumors [ 21 ]. Seventy percent of respondents performed surveillance ureteroscopy.…”

Section: Surveillance Protocolsmentioning

confidence: 99%

“…At present there are no detailed, evidencebased guidelines on the ideal surveillance protocol, which is highlighted by the wide variety of practice patterns. One of the most detailed surveillance protocols has been outlined by the Jefferson University group [ 21 ]. Their institutional protocol consists of cystoscopy, retrograde pyelography and ureteroscopy every 3 months until the patient is disease free.…”

Section: Surveillance Protocolsmentioning

confidence: 99%

Surveillance After Treatment for Upper Tract Transitional Cell Carcinoma

Conlin

Duty

2015

Upper Urinary Tract Urothelial Carcinoma

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Current Practice Patterns in Urologic Management of Upper-Tract Transitional-Cell Carcinoma

Cited by 29 publications

References 54 publications

Nephroureterectomy surgery in the UK in 2012: British Association of Urological Surgeons (BAUS) Registry data

Nephroureterectomy surgery in the UK in 2012: British Association of Urological Surgeons (BAUS) Registry data

Nephroureterectomy for Transitional Cell Carcinoma – The Value of Pre-Operative Histology

Surveillance After Treatment for Upper Tract Transitional Cell Carcinoma

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