Abstract
BackgroundOne of the major concerns of patients with upper tract urothelial carcinoma (UTUC) treated with nephroureterectomy is intravesical recurrence (IVR). The purpose of the present study was to investigate the predictive risk factors for IVR after retroperitoneoscopic nephroureterectomy (RNU) for UTUC.MethodsClinicopathological and surgical information were collected from the medical records of 73 patients treated with RNU for non-metastatic UTUC, without a history of or concomitant bladder cancer. The association between IVR after RNU and clinicopathological and surgery-related factors, including preoperative urine cytology and pneumoretroperitoneum time, was analyzed using the Fisher exact test.ResultsDuring the median follow-up time of 39.1 months, 18 (24.7%) patients had subsequent IVR after RNU. The 1- and 3-year IVR-free survival rates were 85.9% and 76.5%, respectively. The Fisher exact test revealed that prolonged pneumoretroperitoneum time of ≥ 210 min was a risk factor for IVR in 1 year after RNU (p = 0.0358) and positive urine cytology was a risk factor for IVR in 3 years after RNU (p = 0.0352).ConclusionsIn UTUC, the occurrences of IVR in 1 and 3 years after RNU are highly probable when the pneumoretroperitoneum time is prolonged (≥ 210 min) and in patients with positive urine cytology, respectively. Strict follow-up after RNU is more probable recommended for these patients.
Highlights
One of the major concerns of patients with upper tract urothelial carcinoma (UTUC) treated with nephroureterectomy is intravesical recurrence (IVR)
The purpose of the present study was to investigate the association between IVR after retroperitoneoscopic nephroureterectomy (RNU) for UTUC and clinicopathological and surgical factors, including preoperative urine cytology, urinary bladder tumor antigen (BTA), urinary nuclear mitotic apparatus protein (NMP22), and pneumoretroperitoneum time
Patient selection We retrospectively identified 102 patients treated with RNU for non-metastatic UTUC at Nippon Medical School Hospital between 2012 and 2020
Summary
One of the major concerns of patients with upper tract urothelial carcinoma (UTUC) treated with nephroureterectomy is intravesical recurrence (IVR). The purpose of the present study was to investigate the predictive risk factors for IVR after retroperitoneoscopic nephroureterectomy (RNU) for UTUC. Upper tract urothelial carcinoma (UTUC) is a relatively uncommon condition and accounts for 5–10% of all urothelial malignancies [1]. Several studies have investigated the risk factors. Laparoscopic NU (LNU) and retroperitoneoscopic NU (RNU) are being performed globally for UTUC. There have been discussions about whether LNU and RNU increase the risk of postoperative IVR compared to open NU, and a consensus is yet to be reached [9,10,11,12,13].
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