Ureteroscopic Treatment and Surveillance of Upper Urinary Tract Transitional Cell Carcinoma

Keeley, Francis X.; Bibbo, Marluce; Bagley, Demetrius H.

doi:10.1016/s0022-5347(01)64793-1

Cited by 233 publications

(147 citation statements)

References 20 publications

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“…Data on distribution of stage and grade at initial presentation indicate that most patients present with a low stage (Ta-T1) grade 2 or 3 tumour [1,[6][7][8][9]. Stage and grade are the most important prognostic factors for recurrence and survival [7][8][9][10][11], but type of treatment [7] and multifocality [8,12], have also been reported to be important, to a variable extent.…”

Section: Introductionmentioning

confidence: 99%

Trends in epidemiology and treatment of upper urinary tract tumours in the Netherlands 1995–2005: an analysis of PALGA, the Dutch national histopathology registry

et al. 2010

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the next year, of cancer of the renal pelvis or ureter during the period 1995-2005, were included. The number of surgically treated UUT tumours per year, type of treatment and tumour characteristics were recorded. RESULTSThe population consisted of 2321 (67%) men and 1145 (33%) women with a mean age of 68.6 years. The distribution according to side was similar (left 44.1%, right 41.5%), bilateral tumours were rare (0.6%) and most tumours were in the renal pelvis (51.3%). Both the incidence and the incidence rate per 100 000 person-years increased during the study period ( P < 0.001). Most urothelial cancers were grade 2 (40.9%) or 3 (41.2%) and stage Ta (30.6%), T1 (18.1%) or T3 (22.8%). There was an increase in grade 3 ( P = 0.003) and muscle-invasive ( P = 0.003) tumours in men only. Nephroureterectomy was performed in 41.3% of the cases and there was an increasing trend to endoscopic surgery ( P = 0.019), although the absolute number was low. CONCLUSION

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Section: Introductionmentioning

confidence: 99%

Trends in epidemiology and treatment of upper urinary tract tumours in the Netherlands 1995–2005: an analysis of PALGA, the Dutch national histopathology registry

et al. 2010

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“…As a result, they are difficult to diagnose and often nondiagnostic, leading to uncertainty about treatment. The techniques for biopsy as well as specimen handling and processing are crucial and have been described previously [3,4,5]. …”

Section: Discussionmentioning

confidence: 99%

Does Mitosis-Specific Marker Phosphohistone H3 Help the Grading of Upper Tract Urothelial Carcinomas in Cell Blocks?

Solomides¹,

Birbe²,

Nicolaou³

et al. 2012

Acta Cytologica

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Background: Grading upper tract urothelial carcinomas (UTUC) in cell blocks with small distorted tissue fragments can be challenging; interobserver agreement is poor among pathologists. Mitotic figure (MF) counting along with nuclear features is important in grading these tumors. We evaluated the use of the mitotic-specific marker phosphohistone H3 (PHH3) as an adjunct to hematoxylin and eosin (H&E) stain for grading UTUC in cell blocks. Methods: Formalin-fixed, paraffin-embedded tissues from the cell blocks of 61 UTUC were stained with H&E and PHH3 antibody. The grading of tumors was performed independently by 3 pathologists, on both H&E-stained and PHH3 plus H&E-stained slides. The grading system used was the 1973 WHO 3-point grading system. Gradings were compared by all the pathologists for H&E staining versus PHH3 plus H&E staining with the Stuart-Maxwell test of marginal homogeneity that accounts for the matched data. Results: The average pairwise agreement by H&E alone was 55%, and 80% by PHH3 plus H&E. Conclusion: By adding PHH3 immunostain to the H&E, the agreement in grading the carcinomas among the 3 pathologists improved dramatically. PHH3 immunostain may play an important role in grading UTUC in small cell block samples.

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“…9 The holmium laser can also be used to safely ablate upper urinary tract tumors in patients who are not candidates for nephroureterectomy. 10 Moreover, Kuo et al reported that the use of the holmium laser with ureteroscopic access provides a safe and acceptable combination for treating the upper urinary tract in patients with bleeding diatheses. 11 The holmium laser, which is compatible with a small caliber ureteroscope, allows endoscopic ureteral incision to be done easily and precisely.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic ureteral incision using the holmium:YAG laser

Hibi¹,

Kato²,

Mitsui³

et al. 2001

Int J of Urology

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Background: We reviewed the results of endoscopic ureteral incision for benign ureteral stricture, ureteropelvic junction obstruction and ureteroenteroanastomotic stricture using the holmium laser. Methods: We carried out endoscopic ureteral incision using the holmium laser through an 8-Fr semirigid or 6.9-Fr flexible ureteroscope on 17 ureters in 15 patients. Balloon dilatation was not necessary before insertion of the ureteroscope. The stricture was incised with the holmium laser using a 200-365 mm fiber through the working channel of the ureteroscope. After completion of the incision, a 12-Fr double-J catheter was left for 6 weeks. Thereafter patients were followed by renal scan and/or ultrasound and excretory urography at 3-6 month intervals. Results:The mean operative time was 65 min (18-135 min). The stricture resolved completely in 86.7% of cases at an average follow up of 20.5 months (11-32 months). Conclusions:The holmium laser endoscopic ureteral incision was associated with a good outcome in our series. We recommend this procedure to be employed initially because it is less invasive and has a favorable outcome.

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Ureteroscopic Treatment and Surveillance of Upper Urinary Tract Transitional Cell Carcinoma

Abstract: Endoscopic treatment of upper urinary tract transitional cell carcinoma is a reasonable method to treat carefully select patients based on strict indications. Complete endoscopic followup at regular intervals is essential to rule out recurrences.

Cited by 233 publications

References 20 publications

Trends in epidemiology and treatment of upper urinary tract tumours in the Netherlands 1995–2005: an analysis of PALGA, the Dutch national histopathology registry

Trends in epidemiology and treatment of upper urinary tract tumours in the Netherlands 1995–2005: an analysis of PALGA, the Dutch national histopathology registry

Does Mitosis-Specific Marker Phosphohistone H3 Help the Grading of Upper Tract Urothelial Carcinomas in Cell Blocks?

Endoscopic ureteral incision using the holmium:YAG laser

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