Abstract
BackgroundThe appropriate application of various treatment for upper tract urothelial carcinomas (UTUCs) is the key to prolong the survival of UTUC patients. Herein, we used data in our database to assess the oncological outcomes between partial ureterectomy (PU) and radical nephroureterectomy (RNU).MethodsFrom 2007 to 2014, 255 patients with UTUC undergoing PU or RNU in our hospital database were investigated. Perioperative, postoperative data, and pathologic outcomes were obtained from our database. Cancer-specific survival (CSS) was assessed through the Kaplan-Meier method with Cox regression models to test the effect of these two surgery types.ResultsThe mean length of follow-up was 35.8 months (interquartile range 10–47 months). Patients with high pT stage (pT2–4) suffered shorter survival span (HR: 9.370, 95% CI: 2.956–29.697, P < 0.001). There were no significant differences in CSS between PU and RNU (P = 0.964). In the sub-analysis, CSS for RNU and PU showed no significant difference for pTa–1 or pT2–4 tumor patients (P = 0.516, P = 0.475, respectively).ConclusionsPU is not inferior to RNU in oncologic outcomes. Furthermore, PU is generally recognized with less invasive and better renal function preservation compared with RNU. Thus, PU would be rational for specific patients with UTUCs.
Highlights
The appropriate application of various treatment for upper tract urothelial carcinomas (UTUCs) is the key to prolong the survival of Upper tract urothelial carcinoma (UTUC) patients
The proportion of patients with hydronephrosis, hematuria or abnormal renal function in radical nephroureterectomy (RNU) group were close to partial ureterectomy (PU) group (P > 0.05)
The guidelines of the European Association of Urology suggested that PU is a legitimate therapy for small, unifocal, low grade UTUC with no signs of infiltration [2, 7, 9], and indicated that RNU is still the standard treatment for high-risk UTUCs [2, 10]
Summary
The appropriate application of various treatment for upper tract urothelial carcinomas (UTUCs) is the key to prolong the survival of UTUC patients. We used data in our database to assess the oncological outcomes between partial ureterectomy (PU) and radical nephroureterectomy (RNU). Upper tract urothelial carcinomas (UTUCs), as a kind of urothelial carcinomas (UCs), accounting for only 5–10% [1]. 60% of UTUCs are invasive [2]. Seventy to Ninety years old showed the highest morbid risk among all age groups and are three times more ordinary in men [2]. UTUC with pure nonurothelial histology is quite rare, but about 25% of cases have variants. In about 90% of cases, the tumor grade can be determined with a low false negative rate [4]. Ureteroscopic biopsy combining with urinary cytology, Li et al BMC Urology (2019) 19:120
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