1392 ACCURACY AND LIMITATION OF URETEROSCOPY IN DIAGNOSIS OF UPPER URINARY TRACT CANCER

Abstract

You have accessJournal of UrologyTechnology & Instruments: Ureteroscopy1 Apr 20111392 ACCURACY AND LIMITATION OF URETEROSCOPY IN DIAGNOSIS OF UPPER URINARY TRACT CANCER Norihiro Murahashi, Takashige Abe, Toru Harabayashi, Nobuo Shinohara, Ataru Sazawa, Satoru Maruyama, and Katsuya Nonomura Norihiro MurahashiNorihiro Murahashi Sapporo, Japan More articles by this author , Takashige AbeTakashige Abe Sapporo, Japan More articles by this author , Toru HarabayashiToru Harabayashi Sapporo, Japan More articles by this author , Nobuo ShinoharaNobuo Shinohara Sapporo, Japan More articles by this author , Ataru SazawaAtaru Sazawa Sapporo, Japan More articles by this author , Satoru MaruyamaSatoru Maruyama Sapporo, Japan More articles by this author , and Katsuya NonomuraKatsuya Nonomura Sapporo, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1239AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Ureteroscopy can help to detect upper urinary tract cancer (UUTC) or to rule out malignancy. However, few reports examined the clinical course of patients considered free of disease at the first examination. The present study investigated the diagnostic accuracy of ureteroscopy for UUTC and the clinical course of patients who had not been diagnosed as UUTC by ureteroscopy. METHODS Study1 138 patients underwent diagnostic ureteroscopy based on suspected of having UUTC between 1995 and 2009. We reviewed the detection rate of carcinoma diagnosis. Study2 We focused on the patients who had not been diagnosed as UUTC at the first examination. We collected the follow-up data from these patients and examined the predictors of later cancer detection. RESULTS Of the138 pts, 59 (43%) were diagnosed as having cancer on the first examination. Thereafter, 37 underwent nephroureterectomy (NU), 2 did partial ureterectomy and 4 did endoscopic surgery, while 16 were treated by conservative therapy. Of the 37 with NU, carcinoma was not detected in surgical specimens in 3 (8.1%). All of them had concurrent bladder cancer. Of the 79 diagnosed as not having carcinoma at the first exam, 61 were followed for 3 months or longer. Of these, carcinoma was detected in 5 at a median of 55 months follow-up. As the clinical characteristic, the history of bladder cancer (yes/no=19/42, p=0.048) and gross hematuria episode after the exam (yes/no=11/50, p=0.004) were the predictors for the latter cancer detection. CONCLUSIONS Ureteroscopy is a useful modality for diagnosis of UTC. However, the ureteroscopic diagnosis might be carefully interpreted in case of concurrent bladder cancer. Patients, negative for ureteroscopy, who have a history of bladder cancer and continuous gross hematuria would be better under close follow-up because they have higher potential of later cancer detection. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e556 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Norihiro Murahashi Sapporo, Japan More articles by this author Takashige Abe Sapporo, Japan More articles by this author Toru Harabayashi Sapporo, Japan More articles by this author Nobuo Shinohara Sapporo, Japan More articles by this author Ataru Sazawa Sapporo, Japan More articles by this author Satoru Maruyama Sapporo, Japan More articles by this author Katsuya Nonomura Sapporo, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...