You have accessJournal of UrologyCME1 May 2022MP40-08 NOVEL ENDOSCOPIC MANAGEMENT FOR LOCALIZED UPPER URINARY TRACT CARCINOMA USING A PHOTODYNAMIC DIAGNOSIS-GUIDED DUAL LASER ABLATION TECHNIQUE: 3-YEAR FOLLOW-UP RESULTS Takashi Yoshida, Tadashi Matsuda, Chisato Ohe, and Hidefumi Kinoshita Takashi YoshidaTakashi Yoshida More articles by this author , Tadashi MatsudaTadashi Matsuda More articles by this author , Chisato OheChisato Ohe More articles by this author , and Hidefumi KinoshitaHidefumi Kinoshita More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002600.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radical nephroureterectomy (RNU) is the gold standard treatment for localized upper tract urothelial carcinoma (UTUC); however, ureteroscopic surgery (URS) has become a more common treatment option for low-risk cases (<2 cm, low grade, and low stage) or imperative cases (solitary kidneys, bilateral tumors, or impaired renal function). Our group has demonstrated URS using the photodynamic diagnosis-guided dual laser ablation (PDD-DLA) technique (Yoshida T et al. Eur Urol Open Sci. 2021). In this analysis, we evaluated its long-term efficacy in patients with UTUC undergoing PDD-DLA. This study aimed to compare the efficacy of PDD-DLA versus the conventional holmium laser ablation (HLA) to evaluate oncological outcomes. METHODS: The study included ten consecutive patients with UTUC who underwent PDD-DLA between 2017 and 2019, and 16 consecutive patients who underwent HLA between 2006 and 2016 as a historical control group. The primary endpoint for the study was disease progression (defined as a relapsing tumor that could not be continued with a conservative approach and/or distant metastases). Secondary endpoints were to evaluate UTUC recurrence-free survival (RFS) and intravesical recurrence-free survival (IVRFS). The Kaplan-Meier method with log-rank test was used for survival analysis. RESULTS: The baseline characteristics were well balanced between the PDD-DLA and HLA groups in terms of tumor size, tumor grade, and multifocality. The disease progression-free rate was significantly higher among patients treated with PDD-DLA than in the HLA group (median survival: not reached vs. 33.9 months; p=0.025). The UTUC-RFS rate was not significantly different between the two groups (median survival: 21.0 vs. 8.8 months; p=0.139), The IVRFS rate was better in the PDD-DLA group when compared with those treated with HLA (median survival: not reached vs. 22.9 months; p=0.029). CONCLUSIONS: PDD-DLA was beneficial as a kidney-sparing surgery for UTUC with a 3-year follow-up. Furthermore, PDD-DLA prevented IVR when compared with the conventional method. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e676 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Takashi Yoshida More articles by this author Tadashi Matsuda More articles by this author Chisato Ohe More articles by this author Hidefumi Kinoshita More articles by this author Expand All Advertisement PDF DownloadLoading ...
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