Oncological outcome of retroperitoneoscopic nephroureterectomy for upper urinary tract transitional cell carcinoma

Abstract

Objective: To report the oncological outcome of retroperitoneoscopic nephroureterectomy (RNU) with bladder cuff excision for upper urinary tract transitional cell carcinoma (TCC), and to compare the outcome with that of the traditional open nephroureterectomy (ONU). Patients and methods: From January 2001, 48 patients with upper urinary tract TCC were enrolled in the study; 25 had RNU and 23 had ONU. Oncological parameters (disease-free survival and disease-specific survival) were calculated from the time of surgery to the date of last follow up and were analysed by the Kaplan-Meier method. Results: Mean follow up was 24.3 months in the RNU group, significantly shorter than in the ONU group. Bladder recurrence was identified in two patients with grade 3 pathological stage pT3, one patient with grade 3 stage pT2 disease and two patients with grade 2 stage pT2 disease. Multiple organ metastases in the lung, liver and lymph nodes were associated with bladder recurrence in two cases (grade 2 stage pT3, and grade 3 stage pT3). The recurrence rate was 20% (5 of 25 cases) and mean time to recurrence was 9.5 months. In the ONU group, bladder recurrence and metastases developed in four and three patients, respectively. The recurrence rate was 17% (4 of 23 cases) and mean time to recurrence was 23.4 months. No significant difference was detected in the disease-free survival rate and cancer-specific survival rate between the two groups (P = 0.759 and P = 0.866, respectively). Conclusion:The oncological outcome of RNU appears to be equivalent to that of ONU. Moreover, long-term follow up is necessary to evaluate the oncological outcome in comparison to ONU.

Oncological Outcomes of Laparoscopic Nephroureterectomy Versus Open Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: An European Association of Urology Guidelines Systematic Review

“…Only one prospective RCT was reported [9]. The retrospective series were multicentre studies [22,23,34,41,44,49] and single-centre studies [5,[13][14][15][16][17][18][19][20][21][24][25][26][27][28][29][30][31][32][33][35][36][37][38][39][40]42,43,[45][46][47][48]50,51] in six and 34 cases, respectively. Most studies had small sample sizes (only six studies included over 100 patients in each treatment arm [34,41,44,[49][50][51]).…”

Laparoscopic Nephroureterectomy: Oncologic Outcomes and Management of Distal Ureter; Review of the Literature

“…Okegawa et al (2006) compared 25 LNU (mean follow-up 24 months) and 23 ONU (mean follow-up 29 months). In LNU and ONU groups, recurrence rates were 20% and 17% and mean time to recurrence were 9.5 and 23.4 months [20]. Distant metastasis rate was 8% for LNUX and 13% for ONUX.…”

Upper Urinary Tract Transitional Cell Carcinoma. A 10-year Experience

“…Both procedures have statistically comparable bladder recurrence and local recurrence rates. The oncological outcome of retroperitoneoscopic nephroureterectomy appears to be equivalent to that of open nephroureterectomy 21 . Recently, laparoscopic distal ureterectomy with direct re-implantation has been demonstrated to be technically feasible for lowrisk upper urinary tract TCC 22 .…”