The oncologic impact of a delay between diagnosis and radical nephroureterectomy due to diagnostic ureteroscopy in upper urinary tract urothelial carcinomas: results from a large collaborative database

Abstract

Despite the increased time to radical surgery, diagnostic ureteroscopy can be systematically performed for the appraisal of UTUC to refine the therapeutic strategy without significantly affecting oncological outcomes, even for MI lesions.

Diagnostic ureteroscopy for upper tract urothelial carcinoma is independently associated with intravesical recurrence after radical nephroureterectomy

“…Ishikawa et al reached the same conclusion as Nison, and the 2-year bladder recurrence-free survival rate was 60.0% in their URS+group and 58.7% in their control group (10). Luo et al, by contrast, reported that ureteroscopy was associated with an increased incidence of intravesical recurrence in patients with or without a history of bladder cancer (11). In the present study, it is possible that diagnostic ureteroscopy is an procedure.…”

“…To the best of our knowledge, previous studies are sparse, and there is no consistent conclusion on the impact of diagnostic ureteroscopy for intravesical recurrence (9)(10)(11). Therefore, we conducted this study, based on data from a large center in China, to determine whether diagnostic ureteroscopy results in IVR after RNU.…”

Diagnostic Ureteroscopy Prior to Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma Increased the Risk of Intravesical Recurrence

“…The reasons to exclude the other 3 studies from quantitative analysis included no HR available [16] and HRs were for URS-related risk of recurrence (both upper tract and IVR) [12, 15]. A meta-analysis of available HRs revealed that diagnostic URS prior to RNU significantly increased the IVR risk after RNU (HR 1.53, 95% CI 1.31–1.77; p < 0.001; Fig.…”

“…The general descriptions of included studies were summarised in Table 1. Among the included studies, 7 (60%) were from Asian countries [8, 10, 11, 13, 14, 17] and 3 studies were conducted in USA [9, 15, 16] and one in France [12], respectively. A total of 4,057 participants were included in the subsequent meta-analysis, of which 518 patients had a history of TCC in bladder.…”

Kidney-sparing Management Versus Nephroureterectomy for Upper Tract Urothelial Carcinoma: a Systematic Review and Meta-analysis

“…Additionally, laparoscopic nephroureterectomy, extravesical bladder cuff resection and positive surgical margin were also the predictors. Previous ureteroscopy seemed to be an independent intravesical recurrence risk factor (Luo et al, 2013), but it's still controversial (Ishikawa et al, 2010;Gurbuz et al, 2011;Nison et al, 2013). Tumor grade was another impact factor of oncologic outcome.…”