PD43-11 THE USE OF URETERAL ACCESS SHEATH DOES NOT MODIFY THE PATTERN OF DISEASE RECURRENCE DURING CONSERVATIVE MANAGEMENT OF UPPER TRACT UROTHELIAL CARCINOMA

Abstract

You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma I (PD43)1 Sep 2021PD43-11 THE USE OF URETERAL ACCESS SHEATH DOES NOT MODIFY THE PATTERN OF DISEASE RECURRENCE DURING CONSERVATIVE MANAGEMENT OF UPPER TRACT UROTHELIAL CARCINOMA Eugenio* Ventimiglia, Luca Villa, Costantino Abbate, Pietro Dioni, Olivier Traxer, Alberto Briganti, Francesco Montorsi, and Andrea Salonia Eugenio* VentimigliaEugenio* Ventimiglia More articles by this author , Luca VillaLuca Villa More articles by this author , Costantino AbbateCostantino Abbate More articles by this author , Pietro DioniPietro Dioni More articles by this author , Olivier TraxerOlivier Traxer More articles by this author , Alberto BrigantiAlberto Briganti More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Andrea SaloniaAndrea Salonia More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002057.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The use of ureteral access sheath (UAS) during ureteroscopy for conservative management of upper tract urothelial carcinoma (UTUC) has been advocated as beneficial in order to prevent cancer recurrence both in the bladder and the upper urinary tract. However, there is no clear evidence at this regard. We aimed at assessing whether the use of UAS in this setting is able to prevent UTUC recurrence during follow-up ureteroscopy. METHODS: Data from 102 consecutive ureteroscopies performed for UTUC at a single academic center between 2015 and 2020 were included in this analysis. Two experienced endo-urologists performed all the procedures. Ureteroscopies were performed using a digital flexible ureterorenoscope (Flex XC, Karl-Storz). Tumor Ho:YAG laser ablation was performed in every case whenever feasible (VersaPulse PowerSuite 100W, Lumenis) using 1 J and 10 Hz. The use of 10/12 UAS (ReTrace, Porges-Coloplast) was attempted whenever there was no evidence of disease in the ureter according to surgeon’s preference. Multivariable logistic regression models tested the association between the use of UAS and cancer recurrence at follow-up ureteroscopy both in the upper tract and the bladder, accounting for possible differences in terms of age, tumor size and grade. RESULTS: Ureteral access sheath was used in 21 (21%) cases. There were not significant differences in terms of patients and tumor characteristics between cases performed with and without UAS (all p>0.05). During follow-up ureteroscopies, evidence for upper tract and bladder recurrence were found in 52/77 (68%) and 18/77 (23%) cases, respectively. The use of UAS was not associated with a decreased probability of cancer recurrence in the upper tract (OR=1.22; 95%CIs=0.44-3.43; p>0.05) and in the bladder (OR=2.76; 95%CIs=0.87-1.56; p>0.05) after accounting for tumor size, grade, and patient age. CONCLUSIONS: The use of UAS does not seem to prevent the UTUC recurrence during endoscopic follow-up. Both upper urinary tract and bladder recurrence pattern are not modified by the use of UAS. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e735-e735 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Eugenio* Ventimiglia More articles by this author Luca Villa More articles by this author Costantino Abbate More articles by this author Pietro Dioni More articles by this author Olivier Traxer More articles by this author Alberto Briganti More articles by this author Francesco Montorsi More articles by this author Andrea Salonia More articles by this author Expand All Advertisement Loading ...