429 PREDICTORS OF LONG-TERM ONCOLOGICAL OUTCOMES OF LAPAROSCOPIC NEPHROURETERECTOMY FOR UPPER TRACT TCC

Abstract

You have accessJournal of UrologyUrothelial Cancer: Upper Tract Tumors1 Apr 2010429 PREDICTORS OF LONG-TERM ONCOLOGICAL OUTCOMES OF LAPAROSCOPIC NEPHROURETERECTOMY FOR UPPER TRACT TCC Michael Lee, Georges-Pascal Haber, Kazumi Kamoi, Sebastian Crouzet, and Inderbir Gill Michael LeeMichael Lee More articles by this author , Georges-Pascal HaberGeorges-Pascal Haber More articles by this author , Kazumi KamoiKazumi Kamoi More articles by this author , Sebastian CrouzetSebastian Crouzet More articles by this author , and Inderbir GillInderbir Gill More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.499AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Laparoscopic nephroureterectomy (LNU) is now an accepted treatment alternative for patient with upper tract transitional cell carcinoma (UT-TCC). We analyzed factors which predict disease-specific and recurrence-free survival of patients following LNU. METHODS 217 consecutive patients underwent with LNU for UT-TCC between 9/1997 and 2/2008. Data were collected prospectively and retrospectively when missing. Survival was determined from clinical follow up and the Social Security Death Index. Factors affecting disease-specific and recurrence-free survival were analyzed using Cox proportional hazard model. RESULTS At 2, 5 and 8 years overall survival was 72%, 54% and 43%, disease-specific survival was 81%, 76% and 73%, and recurrence-free survival was 64%, 60% and 58%, respectively. In multivariate analysis T stage (muscle invasive) and positive surgical margin were independent predictors for disease-specific survival (P<0.01 for both, Table 1). Five-year disease-specific survival rate was 92% in the non-invasive diseases (127 patients) and 52% in the muscle invasive diseases (90 patients). Positive surgical margin occurred in 20 patients whose median survival was 17 months. In multivariate analysis grade 3 tumor in the pathological specimen was an independent predictor for recurrence-free survival (p<0.05, Table 2). Five-year recurrence-free survival rates were 79% in the patients without grade 3 tumor (71 patients) and 49% in the patients with grade 3 tumor (146 patients). CONCLUSIONS Long-term oncological outcomes for LNU appear comparable to those of open surgery. For patients undergoing LNU, T stage 2 or higher was an independent predictor for disease-specific survival and tumor grade 3 was an independent predictor for recurrence-free survival. Patients with positive surgical margin had overall poor prognosis. Cleveland, OH© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e169-e170 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Lee More articles by this author Georges-Pascal Haber More articles by this author Kazumi Kamoi More articles by this author Sebastian Crouzet More articles by this author Inderbir Gill More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...