The Comparison of Oncologic Outcomes between Open and Laparoscopic Radical Nephroureterectomy for the Treatment of Upper Tract Urothelial Carcinoma: A Korean Multicenter Collaborative Study

Kim, Tae Heon; Hong, Bumsik; Seo, Ho Kyung; Kang, Seok Ho; Ku, Ja Hyeon; Jeong, Byong Chang

doi:10.4143/crt.2017.417

Cited by 15 publications

(19 citation statements)

References 22 publications

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“…The impact of chemotherapy for UTUC is still under debate, especially neoadjuvant chemotherapy. Furthermore, some reports showed that receipt of adjuvant chemotherapy was not related to disease progression, death from UTUC, and all-cause death 24 . Management of regional lymph nodes differed among patients because of the retrospective design and absence of a standardized template for lymph node dissection.…”

Section: Discussionmentioning

confidence: 99%

Transperitoneal radical nephroureterectomy is associated with worse disease progression than retroperitoneal radical nephroureterectomy in patients with upper urinary tract urothelial carcinoma

Kim

Suh

Jeon

et al. 2019

Sci Rep

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This study aimed to compare the oncologic outcomes between retroperitoneal radical nephroureterectomy (rRNU) and transperitoneal radical nephroureterectomy (tRNU) for the treatment of patients with upper urinary tract urothelial carcinoma (UTUC). Medical records of 743 eligible patients who underwent rRNU or tRNU between 1995 and 2015 were reviewed retrospectively. Progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS) were compared according to the surgical approach using the Kaplan–Meier method. Predictors of PFS, CSS, and OS were analyzed with a multivariable Cox regression model. Overall, 620 (83.4%) and 123 (16.6%) patients were treated with rRNU and tRNU, respectively. Five-year CSS and OS rates were equivalent between rRNU and tRNU groups, but 5-year PFS was lower in the tRNU group than the rRNU group ( P = 0.005). When patients were stratified by pathological T stage, PFS was significantly different between the two groups in favor of the rRNU group for both organ-confined disease (pTis/pTa/pT1/T2) ( P = 0.022) and locally advanced disease (pT3/pT4) ( P = 0.039). However, no significant differences in CSS or OS was observed when comparing the two surgical types in patients with organ-confined disease ( P = 0.336 and P = 0.851) or patients with locally advanced disease ( P = 0.499 and P = 0.278). tRNU was a significant predictor of PFS (hazard ratio = 1.54; P = 0.023), but not CSS or OS. Our findings indicate that the rRNU approach resulted in better PFS than the tRNU approach in patients with UTUC.

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Section: Discussionmentioning

confidence: 99%

Transperitoneal radical nephroureterectomy is associated with worse disease progression than retroperitoneal radical nephroureterectomy in patients with upper urinary tract urothelial carcinoma

Kim

Suh

Jeon

et al. 2019

Sci Rep

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“…There is an unusual presentation of high prevalence and female predominance for upper UTUC in the Taiwan and China area . In other Asian areas, such as Japan and Korea, European and American countries, the male:female ratio is from 1.223:2.860 . However, the male:female ratio in Taiwan and China is 0.773:0.838 .…”

Section: Introductionmentioning

confidence: 98%

“…[1][2][3] In other Asian areas, such as Japan and Korea, European and American countries, the male:female ratio is from 1.223:2.860. [4][5][6][7] However, the male:female ratio in Taiwan and China is 0.773:0.838. [1][2][3] Several reports attributed this phenomenon to carcinogen exposure, such as arsenic and aristolochic acid.…”

Section: Introductionmentioning

confidence: 99%

Unusual presentation of upper urinary tract urothelial carcinoma in Taiwan: Direct comparison from Taiwan‐Japan UTUC Collaboration Cohort

et al. 2020

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Objectives To carry out a comparison of upper urinary tract urothelial carcinoma characteristics and behavior between patients in Taiwan and Japan. Methods A Taiwan urinary tract urothelial carcinoma cohort was obtained from Kaohsiung Chang Gung Memorial Hospital, and a Japan urinary tract urothelial carcinoma cohort from Hirosaki University Hospital. The inclusion criteria were urinary tract urothelial carcinoma patients who underwent radical nephroureterectomy. Those who received perioperative chemotherapy were excluded. Finally, 765 patients in the Taiwan cohort and 325 in the Japan cohort were analyzed. The end‐point of this study was to study the natural course of urinary tract urothelial carcinoma within 5 years between these two groups. Results The main finding was that urinary tract urothelial carcinoma patients in Taiwan were younger (P < 0.001), more were women (P < 0.001), with low‐stage disease (P < 0.001), with more chronic kidney disease (P < 0.001), with less smoking history (P < 0.001), with more bladder cancer history (P = 0.002), with more multifocal (P < 0.001) and less high‐grade disease (P = 0.015), as well as less lymphovascular invasion (P < 0.001) and more squamous differentiation (P < 0.001). However, the multivariate Cox regression analysis showed no racial difference in oncologic outcome, such as intravesical recurrence, systemic recurrence or cancer‐specific death in primary and propensity‐matched cohorts. Bladder cancer history was found to be the most important factor predicting intravesical recurrences, whereas stage was strongly associated with systemic recurrence and cancer specific mortality. Conclusions The clinical characteristics of urinary tract urothelial carcinoma in Taiwan are significantly different from those of urinary tract urothelial carcinoma in Japan. However, there is no racial difference in stage‐specific oncologic outcome after standard nephroureterectomy.

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“…The institutional review board of each multicenter institution approved this study, including the National Cancer Center (NCC-2016-0040 and 2018-0114-0001) [ 12 ]. The requirement for written informed consent was waived because of the retrospective design of the study.…”

Section: Methodsmentioning

confidence: 99%

“…Based on a previously published paper of the original UCART data set,[ 12 ] the methodology of ONU or LNU and the postoperative follow-up protocols were not standardized but were performed at the surgeon’s discretion. Unless the patient was contraindicated for laparoscopic surgery such as a history of abdominal surgery or high body mass indices, the LNU was indicated as the first surgical choice.…”

Section: Methodsmentioning

confidence: 99%

A retrospective multicenter comparison of conditional cancer-specific survival between laparoscopic and open radical nephroureterectomy in locally advanced upper tract urothelial carcinoma

Kim

Song

et al. 2021

PLoS ONE

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Background Upper urinary tract urothelial carcinomas are relatively rare and have a cancer-specific survival rate of 20%–30%. The current gold standard treatment for nonmetastatic high-grade urinary tract urothelial carcinoma is radical nephroureterectomy with bladder cuff resection. Objective This study aimed to compare conditional cancer-specific survival between open radical nephroureterectomy and laparoscopic radical nephroureterectomy in patients with nonmetastatic stage pT3-4 or TxN(+) locally advanced urinary tract urothelial carcinoma from five tertiary centers. Methods The medical records of 723 patients were retrospectively reviewed. The patients had locally advanced and nodal staged tumors and had undergone open radical nephroureterectomy (n = 388) or laparoscopic radical nephroureterectomy (n = 260) at five tertiary Korean institutions from January 2000 and December 2012. To control for heterogenic baseline differences between the two modalities, propensity score matching and subgroup analysis were conducted. Conditional survival analysis was also conducted to determine survival outcome and to overcome differences in follow-up duration between the groups. Results During the median 50.8-month follow up, 255 deaths occurred. In univariate analysis, significant factors affecting cancer-specific survival (e.g., age, history of bladder cancer, American Society of Anesthesiologists score, pathological N stage, and presence of lymphovascular invasion and carcinoma in situ) differed in each subsequent year. The cancer-specific survival between patients treated with open radical nephroureterectomy and laparoscopic radical nephroureterectomy was not different between patients with and without a history of bladder cancer. After adjusting baseline differences between the two groups by using propensity score matching, both groups still had no significant differences in cancer-specific survival. Conclusion The two surgical modalities showed no significant differences in the 5-year cancer-specific survival in patients with locally advanced urinary tract urothelial carcinoma.

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The Comparison of Oncologic Outcomes between Open and Laparoscopic Radical Nephroureterectomy for the Treatment of Upper Tract Urothelial Carcinoma: A Korean Multicenter Collaborative Study

Abstract: Our findings indicate that LNU provided better oncologic control of IVRFS, CSS, and OS compared with ONU for the management of patients with UTUC.

Cited by 15 publications

References 22 publications

Transperitoneal radical nephroureterectomy is associated with worse disease progression than retroperitoneal radical nephroureterectomy in patients with upper urinary tract urothelial carcinoma

Transperitoneal radical nephroureterectomy is associated with worse disease progression than retroperitoneal radical nephroureterectomy in patients with upper urinary tract urothelial carcinoma

Unusual presentation of upper urinary tract urothelial carcinoma in Taiwan: Direct comparison from Taiwan‐Japan UTUC Collaboration Cohort

A retrospective multicenter comparison of conditional cancer-specific survival between laparoscopic and open radical nephroureterectomy in locally advanced upper tract urothelial carcinoma

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