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The clinical impact of ureteroscopy for upper tract urothelial carcinoma: A multicenter study.
Nakano, Juria; Urabe, Fumihiko; Kiuchi, Yuria; Takamizawa, Shigeyoshi; Suzuki, Hirotaka; Kawano, Shota; Miyajima, Keiichiro; Fukuokaya, Wataru; Takahashi, Kazuhiro; Iwatani, Kosuke; Imai, Yu; Kayano, Sotaro; Aikawa, Koichi; Yanagisawa, Takafumi; Tashiro, Kojiro; Yuen, Steffi; Sato, Shun; Tsuzuki, Shunsuke; Miki, Jun; Kimura, Takahiro.
Afiliación
  • Nakano J; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
  • Urabe F; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
  • Kiuchi Y; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
  • Takamizawa S; Department of Urology, Jikei University Kashiwa Hospital, Chiba, Japan.
  • Suzuki H; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
  • Kawano S; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
  • Miyajima K; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
  • Fukuokaya W; Department of Urology, Jikei University Kashiwa Hospital, Chiba, Japan.
  • Takahashi K; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
  • Iwatani K; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
  • Imai Y; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
  • Kayano S; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
  • Aikawa K; Department of Urology, Jikei University Kashiwa Hospital, Chiba, Japan.
  • Yanagisawa T; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
  • Tashiro K; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
  • Yuen S; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
  • Sato S; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
  • Tsuzuki S; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
  • Miki J; Department of Urology, Jikei Katsushika Medical Center, Tokyo, Japan.
  • Kimura T; Division of Urology, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
Int J Urol ; 31(4): 394-401, 2024 Apr.
Article en En | MEDLINE | ID: mdl-38151321
ABSTRACT

BACKGROUND:

With the development of kidney-sparing surgery and neoadjuvant chemotherapy, ureteroscopic biopsy (URSBx) has become important for the management of upper tract urothelial carcinoma (UTUC).

METHODS:

We retrospectively analyzed data from 744 patients with UTUC who underwent radical nephroureterectomy (RNU), stratified into no ureteroscopy (URS), URS alone, and URSBx groups. Intravesical recurrence-free survival (IVRFS) was examined using the Kaplan-Meier method. We conducted Cox regression analyses to identify risk factors for IVR. We investigated differences between clinical and pathological staging to assess the ability to predict the pathological tumor stage and grade of RNU specimens.

RESULTS:

Kaplan-Meier curves and multivariate Cox regression revealed significantly more IVR and inferior IVRFS in patients who underwent URS and URSBx. Superficial, but not invasive, bladder cancer recurrence was more frequent in the URS and URSBx groups than in the no URS group. Clinical and pathological staging agreed for 55 (32.4%) patients. Downstaging occurred for 48 (28.2%) patients and clinical understaging occurred for 67 (39.4%) patients. Upstaging to muscle-invasive disease occurred for 39 (35.8%) of 109 patients with ≤cT1 disease. Clinical and pathological grading were similar for 72 (42.3%) patients. Downgrading occurred for 5 (2.9%) patients, and clinical undergrading occurred for 93 (54.7%) patients.

CONCLUSION:

URS and URSBx instrumentation will be risk factors for superficial, but not invasive, bladder cancer recurrence. Clinical understaging/undergrading and upstaging to muscle-invasive disease occurred for a large proportion of patients with UTUC who underwent RNU. These data emphasize the challenges involved in accurate UTUC staging and grading.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Ureterales / Neoplasias de la Vejiga Urinaria / Carcinoma de Células Transicionales Límite: Humans Idioma: En Revista: Int J Urol Asunto de la revista: UROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Australia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Ureterales / Neoplasias de la Vejiga Urinaria / Carcinoma de Células Transicionales Límite: Humans Idioma: En Revista: Int J Urol Asunto de la revista: UROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Australia