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Diagnostic Ureteroscopy for Upper Tract Urothelial Carcinoma is Independently Associated with Intravesical Recurrence after Radical Nephroureterectomy

PURPOSE: To determine the effect of diagnostic ureteroscopy on intravesical recurrence in patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). MATERIALS AND METHODS: We conducted a retrospective analysis of 664 patients who were treated with RNU for UTUC from...

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Autores principales: Liu, Pei, Su, Xiao-hong, Xiong, Geng-Yan, Li, Xue-Song, Zhou, Li-Qun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Urologia 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5117968/
https://www.ncbi.nlm.nih.gov/pubmed/27509369
http://dx.doi.org/10.1590/S1677-5538.IBJU.2015.0366
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author Liu, Pei
Su, Xiao-hong
Xiong, Geng-Yan
Li, Xue-Song
Zhou, Li-Qun
author_facet Liu, Pei
Su, Xiao-hong
Xiong, Geng-Yan
Li, Xue-Song
Zhou, Li-Qun
author_sort Liu, Pei
collection PubMed
description PURPOSE: To determine the effect of diagnostic ureteroscopy on intravesical recurrence in patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). MATERIALS AND METHODS: We conducted a retrospective analysis of 664 patients who were treated with RNU for UTUC from June 2000 to December 2011, excluding those who had concomitant/prior bladder tumors. Of the 664 patients, 81 underwent diagnostic ureteroscopy (URS). We analyzed the impact of diagnostic ureteroscopy on intravesical recurrence (IVR) using the Kaplan-Meier method. Univariate and multivariate analyses were used to determine the independent risk factors. RESULTS: The median follow-up time was 48 months (interquartile range (IQR): 31-77 months). Patients who underwent ureteroscopy were more likely to have a small (p<0.01), early-staged (p=0.019), multifocality (p=0.035) and ureteral tumor (p<0.001). IVR occurred in 223 patients during follow-up within a median of 17 months (IQR: 7-33). Patients without preoperative ureteroscopy have a statistically significant better 2-year (79.3%±0.02 versus 71.4%±0.02, p<0.001) and 5-year intravesical recurrence-free survival rates (64.9%±0.05 versus 44.3%±0.06, p<0.001) than patients who underwent ureteroscopy. In multivariate analysis, the diagnostic ureteroscopy (p=0.006), multiple tumors (p=0.001), tumor size <3cm (p=0.008), low-grade (p=0.022) and pN(0) stage tumor (p=0.045) were independent predictors of IVR. CONCLUSIONS: Diagnostic ureteroscopy is independently associated with intravesical recurrence after radical nephroureterectomy.
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spelling pubmed-51179682016-11-22 Diagnostic Ureteroscopy for Upper Tract Urothelial Carcinoma is Independently Associated with Intravesical Recurrence after Radical Nephroureterectomy Liu, Pei Su, Xiao-hong Xiong, Geng-Yan Li, Xue-Song Zhou, Li-Qun Int Braz J Urol Original Article PURPOSE: To determine the effect of diagnostic ureteroscopy on intravesical recurrence in patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). MATERIALS AND METHODS: We conducted a retrospective analysis of 664 patients who were treated with RNU for UTUC from June 2000 to December 2011, excluding those who had concomitant/prior bladder tumors. Of the 664 patients, 81 underwent diagnostic ureteroscopy (URS). We analyzed the impact of diagnostic ureteroscopy on intravesical recurrence (IVR) using the Kaplan-Meier method. Univariate and multivariate analyses were used to determine the independent risk factors. RESULTS: The median follow-up time was 48 months (interquartile range (IQR): 31-77 months). Patients who underwent ureteroscopy were more likely to have a small (p<0.01), early-staged (p=0.019), multifocality (p=0.035) and ureteral tumor (p<0.001). IVR occurred in 223 patients during follow-up within a median of 17 months (IQR: 7-33). Patients without preoperative ureteroscopy have a statistically significant better 2-year (79.3%±0.02 versus 71.4%±0.02, p<0.001) and 5-year intravesical recurrence-free survival rates (64.9%±0.05 versus 44.3%±0.06, p<0.001) than patients who underwent ureteroscopy. In multivariate analysis, the diagnostic ureteroscopy (p=0.006), multiple tumors (p=0.001), tumor size <3cm (p=0.008), low-grade (p=0.022) and pN(0) stage tumor (p=0.045) were independent predictors of IVR. CONCLUSIONS: Diagnostic ureteroscopy is independently associated with intravesical recurrence after radical nephroureterectomy. Sociedade Brasileira de Urologia 2016 /pmc/articles/PMC5117968/ /pubmed/27509369 http://dx.doi.org/10.1590/S1677-5538.IBJU.2015.0366 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Liu, Pei
Su, Xiao-hong
Xiong, Geng-Yan
Li, Xue-Song
Zhou, Li-Qun
Diagnostic Ureteroscopy for Upper Tract Urothelial Carcinoma is Independently Associated with Intravesical Recurrence after Radical Nephroureterectomy
title Diagnostic Ureteroscopy for Upper Tract Urothelial Carcinoma is Independently Associated with Intravesical Recurrence after Radical Nephroureterectomy
title_full Diagnostic Ureteroscopy for Upper Tract Urothelial Carcinoma is Independently Associated with Intravesical Recurrence after Radical Nephroureterectomy
title_fullStr Diagnostic Ureteroscopy for Upper Tract Urothelial Carcinoma is Independently Associated with Intravesical Recurrence after Radical Nephroureterectomy
title_full_unstemmed Diagnostic Ureteroscopy for Upper Tract Urothelial Carcinoma is Independently Associated with Intravesical Recurrence after Radical Nephroureterectomy
title_short Diagnostic Ureteroscopy for Upper Tract Urothelial Carcinoma is Independently Associated with Intravesical Recurrence after Radical Nephroureterectomy
title_sort diagnostic ureteroscopy for upper tract urothelial carcinoma is independently associated with intravesical recurrence after radical nephroureterectomy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5117968/
https://www.ncbi.nlm.nih.gov/pubmed/27509369
http://dx.doi.org/10.1590/S1677-5538.IBJU.2015.0366
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