Upper Tract Transitional Cell Carcinoma Research Articles

Bladder Cancer: Upper Tract Transitional Cell Carcinoma III (PD41)

Bladder Cancer: Upper Tract Transitional Cell Carcinoma III (PD41)

Bladder Cancer: Upper Tract Transitional Cell Carcinoma I (PD20)

Bladder Cancer: Upper Tract Transitional Cell Carcinoma I (PD20)

Bladder Cancer: Upper Tract Transitional Cell Carcinoma II (MP38)

Bladder Cancer: Upper Tract Transitional Cell Carcinoma II (MP38)

Upper tract transitional cell carcinoma: An array of imaging conundrum

We report a 38-year-old gentleman who presented with painless haematuria for 6-months duration. Contrast-enhanced CT renal revealed a large, calcified intrapelvic mass with calyceal extension confined within the right kidney with moderate pelvicalyceal dilatation but no evidence of synchronous lesion elsewhere. Histopathological analysis showed high grade urothelial carcinoma of the renal pelvis with invasion of renal parenchyma. Upper tract urothelial carcinoma (UTUC) which was once thought similar to urothelial carcinoma of the bladder (UCB), is increasingly being recognized as a different entity. However, heterogenous array of imaging manifestations of UTUC is also increasingly being encountered and pose diagnostic challenges though UTUC is not as prevalent as UCB which is easier to diagnose. Despite distinctive features against renal cell carcinoma (RCC), UTUC may mimic numerous other renal pathologies especially the benign ones hence imaging plays a pivotal role in ascertaining the diagnosis. This disease is usually treated with radical nephroureterectomy with superadded neoadjuvant chemotherapy for high-risk cases. Less invasive endoscopic resection is also offered in certain cases but stringent surveillance of the whole urinary tract as well as post-operative follow-up are mandatory.

69 Is CT Urogram Screening Necessary in All Patients with Visible Haematuria in Both the Immediate and Short-Term Follow-Up Period?

Abstract Introduction A standardised specific investigation protocol for visible haematuria (VH) screening remains a debate. A recent regional audit highlighted our department as an outlier for the high useage of CT urogram (CTU). We sought to determine the incidence of upper tract cancer (UTC) in a VH cohort, exploring the benefit of routine CTU versus the possibility of developing a selective patient-centred approach. Method Retrospective case-note review of all 2-week-wait patients referred for VH from May-October 2018. Data was analysed to describe the incidence of bladder transitional cell carcinoma (TCC), upper tract transitional cell carcinoma (UTTCC) and renal cell carcinoma (RCC); the detection rate of CTU and the missed rate of UTC over the following four years. Results 437 patients (334 men, 103 women; age range 21-95 years, median age 71 years; 35% smokers, 45% non-smokers, 18% smoking status unknown) underwent VH screening with a cancer detection rate comparable to previous literature (18% TCC, 1.4% RCC, 1% UTTCC). 73% (n = 321) underwent CTU, 52% (n = 229) underwent CTU and ultrasound (USS). USS missed one RCC subsequently detected by CTU. 72.7% and 63.6% of those diagnosed with UTC (age range 57- 86, mean age 71 years) were male or smokers, respectively. 43% (n = 189) received further upper tract imaging during the subsequent four years, with one further RCC detected. Conclusions The additional detection rate of CTU and subsequent development of UTC was minimal within our cohort suggesting the use of CTU in VH screening could be selective rather than routine.

Bladder Cancer: Upper Tract Transitional Cell Carcinoma I (MP69)

You have accessJournal of UrologyCME1 Apr 2023Bladder Cancer: Upper Tract Transitional Cell Carcinoma I (MP69) View All Author Informationhttps://doi.org/10.1097/JU.0000000000003332AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Expand All Advertisement PDF downloadLoading ...

Bladder Cancer: Upper Tract Transitional Cell Carcinoma II (PD46)

You have accessJournal of UrologyCME1 Apr 2023Bladder Cancer: Upper Tract Transitional Cell Carcinoma II (PD46) View All Author Informationhttps://doi.org/10.1097/JU.0000000000003359AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Expand All Advertisement PDF downloadLoading ...

Bilateral nephrolithiasis and upper tract transitional cell carcinoma in horseshoe kidney

Nephroureterectomy is currently the criterion-standard treatment for high-grade upper tract urothelial carcinoma. Current guidelines and expert opinions propose some exceptions to this approach based on patient characteristics, disease status, and function of the contralateral kidney. We present a rare case of a patient with horseshoe kidney, bilateral large nephrolithiasis, high-grade upper tract urothelial carcinoma in one moiety, and relative parenchymal thinning of the contralateral side. The patient was treated with a percutaneous, minimally invasive, nephron sparing approach. The patient also had intracollecting system instillations of gemcitabine and docetaxel. Minimally invasive percutaneous resection of high-grade upper tract urothelial carcinoma is a safe procedure in select cases. Current guidelines may not apply to all patients; unique scenarios with upper tract urothelial carcinoma may require personalized decision-making and treatment at specialized centers.

Bladder Cancer: Upper Tract Transitional Cell Carcinoma I (MP40)

Bladder Cancer: Upper Tract Transitional Cell Carcinoma I (MP40)

Retrocaval ureter coexisting with renal cell carcinoma: A case report and review of literature

Background: Retrocaval Ureter (RCU) is a rare congenital anomaly that often presents with obstructive changes in the upper urinary tract which may or may not symptomatic. It arises as a result of an aberration in embryologic development of Inferior Vena Cava (IVC). Commonly occurs in isolation but can occur in association with other anomalies. Few studies have reported RCU co-existing with upper tract Transitional Cell Carcinoma (TCC) but there is no literature report so far of its co-existence with Renal Cell Carcinoma (RCC). Case summary: Hence, we report a case of a 65 year old man with right sided RCC coexisting with RCU. The anomaly was discovered intra-operatively and the patient was offered open right radical nephrectomy with a good post-operative recovery and uneventful follow-up. Conclusion: Retrocaval ureter is a rare congenital anomaly that may occur in isolation or with other associated conditions. To the best of our knowledge, we report the first case of RCU coexisting with renal cell carcinoma. Proper pre-operative evaluation will help to identify these associated anomalies so as to adopt a holistic approach to patient care in order to ensure good treatment outcome. Keywords: radical nephrectomy; renal cell carcinoma; retrocaval ureter; nephroureterectomy.

PD43-12 WHAT PART DOES URETEROSCOPY PLAY IN THE DIAGNOSTIC PATHWAY OF UPPER TRACT TRANSITIONAL CARCINOMA? A TWO-YEAR REVIEW IN A HIGH-VOLUME INSTITUTION

You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma I (PD43)1 Sep 2021PD43-12 WHAT PART DOES URETEROSCOPY PLAY IN THE DIAGNOSTIC PATHWAY OF UPPER TRACT TRANSITIONAL CARCINOMA? A TWO-YEAR REVIEW IN A HIGH-VOLUME INSTITUTION Radha Sehgal, Shifa Wong, Yasmin Abu-Ghanem, Theodore Birks, Rajesh Kucheria, Darrell Allen, Anuj Goyal, Paras Singh, Leye Ajayi, and Gidon Ellis Radha SehgalRadha Sehgal More articles by this author , Shifa WongShifa Wong More articles by this author , Yasmin Abu-GhanemYasmin Abu-Ghanem More articles by this author , Theodore BirksTheodore Birks More articles by this author , Rajesh KucheriaRajesh Kucheria More articles by this author , Darrell AllenDarrell Allen More articles by this author , Anuj GoyalAnuj Goyal More articles by this author , Paras SinghParas Singh More articles by this author , Leye AjayiLeye Ajayi More articles by this author , and Gidon EllisGidon Ellis More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002057.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ureteroscopy (URS) is an established diagnostic tool in the diagnosis of upper tract urothelial carcinoma (UTUC); it enables exclusion of UTUC in cases of diagnostic uncertainty and facilitates endoscopic kidney-sparing management in selected cases. However, its use is controversial due to the potential risk of tumour seeding into the bladder and delays incurred in the diagnostic pathway. We aim to review the diagnostic value of URS a large cohort of patients investigated for UTUC. METHODS: We performed retrospective review of diagnostic URS at our institution for suspected UTUC between January 2018 to December 2019. Demographics, CT urogram (CTU) findings, cytology and intra-operative appearances were obtained from electronic records. Histology was recorded from ureteroscopic biopsy and where applicable, final radical nephroureterectomy (RNU). RESULTS: A total of 161 diagnostic URS were performed for suspected UTUC. Patients presented predominantly with haematuria (42%). Pre-operative CTU w demonstrated a filling defect/lesion (48%), hydronephrosis (25%), urothelial thickening (21%) or no abnormality (6%), where URS was performed due to persistent haematuria or blood from the ureteric orifice at cystoscopy. Selective cytology was positive in 34 cases (27%). Urothelium was visually suspicious in 71 cases (44%) and biopsy results were malignant in 41 cases (25%). A diagnosis of UTUC was confirmed based on cytology and histology in 47 cases (29%). Of these, 31 patients (66%) underwent RNU, 14 patients (30%) underwent kidney-sparing management and 2 patients (4%) were unfit for further surgery. Two patients underwent RNU where the final histology was not UTUC (renal cell carcinoma and renomedullary interstital tumour). Following a negative URS, 68 patients (54%) were discharged or reassured and 8 patients (6%) were referred to other specialties for non-urothelial tumours. CONCLUSIONS: Diagnostic URS is crucial in accurately diagnosing and staging UTUC. Of the 47 confirmed cases of UTUC, 30% of patients underwent kidney-sparing management. RNU was avoided in 61% of patients who were subsequently discharged following negative URS or diagnosed with non-urothelial tumours. We conclude that in cases of diagnostic uncertainty and where kidney-sparing management is feasible, URS should remain in the diagnostic pathway of UTUC. Further research into diagnostic pathway delays and intravesical recurrence in this cohort is ongoing. Source of Funding: N/A © 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 Radha Sehgal More articles by this author Shifa Wong More articles by this author Yasmin Abu-Ghanem More articles by this author Theodore Birks More articles by this author Rajesh Kucheria More articles by this author Darrell Allen More articles by this author Anuj Goyal More articles by this author Paras Singh More articles by this author Leye Ajayi More articles by this author Gidon Ellis More articles by this author Expand All Advertisement Loading ...

Bladder Cancer: Upper Tract Transitional Cell Carcinoma I (PD43)

Bladder Cancer: Upper Tract Transitional Cell Carcinoma I (PD43)

PD10-07 UPPER TRACT IMAGING IN PATIENTS WITH HAEMATURIA

You have accessJournal of UrologyImaging/Radiology: Uroradiology I (PD10)1 Sep 2021PD10-07 UPPER TRACT IMAGING IN PATIENTS WITH HAEMATURIA Shanmugasigamani Kannan, Ashok Bhuvanagiri, Ashok Kailasa, Kyriacos Alexandrou, Mohanarangam Thangavelu, and Jason Walker Shanmugasigamani KannanShanmugasigamani Kannan More articles by this author , Ashok BhuvanagiriAshok Bhuvanagiri More articles by this author , Ashok KailasaAshok Kailasa More articles by this author , Kyriacos AlexandrouKyriacos Alexandrou More articles by this author , Mohanarangam ThangaveluMohanarangam Thangavelu More articles by this author , and Jason WalkerJason Walker More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001978.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To evaluate the range of pathologies identified in patients attending the One Stop Haematuria Clinic (OSHC) and to examine the value of Ultrasound Urinary tract (USS KUB) and CT Urogram in these patients. METHODS: This was a prospective study of 2110 patients (Males 1,112 (52.7%) Females 998(47.3%)) referred to OSHC with visible haematuria (VH, n = 1163 (55.1%)) or non-visible haematuria (NVH, n = 947 (44.9%)) between April 2017 and Jan2021. The mean age was 68.4 years (range 45-92). All patients were investigated by flexible cystoscopy and USS KUB, 1154/2110 (54.6%) had a CT Urogram. Data were collected from Welsh Clinical Portal, Welsh Clinical Communications Gateway and Synapse Radiology system. RESULTS: In Low Risk Group (NVH and Age <50, Non-smoker, Sex – Male <40 yrs, Female <50yrs) 315 USS KUB were normal except 1 patient had complex cyst confirmed as Bosniak2f cyst on CT scan. All renal masses were diagnosed on Ultrasound Scan. There were 33/2110 (1.5%) patients diagnosed as Upper Tract Transitional cell Carcinoma (UTTCC) on CTU. Mean age of this group was 71.2 (SD - 10.7) years and there was no statistical difference in Low and high risk group for UTTCC (p-Value 0.19). CONCLUSIONS: On the basis of these results there is no need for CT Urogram for assessment of non visible haematuria patients unless other risk factors (Age >65 years, Visible Haematuria, abnormal USS) are present. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e129-e129 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shanmugasigamani Kannan More articles by this author Ashok Bhuvanagiri More articles by this author Ashok Kailasa More articles by this author Kyriacos Alexandrou More articles by this author Mohanarangam Thangavelu More articles by this author Jason Walker More articles by this author Expand All Advertisement Loading ...

Bladder Cancer: Upper Tract Transitional Cell Carcinoma II (MP48)

Bladder Cancer: Upper Tract Transitional Cell Carcinoma II (MP48)

MP48-13 BLADDER RECURRENCE FOLLOWING DIAGNOSTIC URETEROSCOPY IN PATIENTS UNDERGOING NEPHROURETERECTOMY FOR UPPER TRACT UROTHELIAL CANCER: IS URETERAL ACCESS SHEATH PROTECTIVE?

You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma II (MP48)1 Sep 2021MP48-13 BLADDER RECURRENCE FOLLOWING DIAGNOSTIC URETEROSCOPY IN PATIENTS UNDERGOING NEPHROURETERECTOMY FOR UPPER TRACT UROTHELIAL CANCER: IS URETERAL ACCESS SHEATH PROTECTIVE? Antoin Douglawi, Alireza Ghoreifi, Ryan Lee, Sanam Seyedian, Jie Cai, Gus Miranda, Wenhao Yu, Gerhard Fuchs, Sumeet Bhanvadia, Anne Schuckman, Mihir Desai, Siamak Daneshmand, Monish Aron, Rene Sotelo, Inderbir Gill, and Hooman Djaladat Antoin DouglawiAntoin Douglawi More articles by this author , Alireza GhoreifiAlireza Ghoreifi More articles by this author , Ryan LeeRyan Lee More articles by this author , Sanam SeyedianSanam Seyedian More articles by this author , Jie CaiJie Cai More articles by this author , Gus MirandaGus Miranda More articles by this author , Wenhao YuWenhao Yu More articles by this author , Gerhard FuchsGerhard Fuchs More articles by this author , Sumeet BhanvadiaSumeet Bhanvadia More articles by this author , Anne SchuckmanAnne Schuckman More articles by this author , Mihir DesaiMihir Desai More articles by this author , Siamak DaneshmandSiamak Daneshmand More articles by this author , Monish AronMonish Aron More articles by this author , Rene SoteloRene Sotelo More articles by this author , Inderbir GillInderbir Gill More articles by this author , and Hooman DjaladatHooman Djaladat More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002074.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radical nephroureterectomy (RNU) remains the gold standard for treatment of upper tract urothelial carcinoma (UTUC). Intravesical recurrence after RNU occurs relatively frequently in up to 50% of patients but the contributing factors are not well defined. We aim to examine the effect of diagnostic ureteroscopy (URS) on bladder recurrence following RNU. METHODS: Using our IRB approved UTUC database, we retrospectively reviewed the records of patients who underwent RNU between 2005-2019. Patients with a prior history of bladder cancer as well as those who did not have bladder cuff resection were excluded. Bladder recurrence was the primary outcome and cox regression model was used to assess the impact of diagnostic URS adjusting for other factors. RESULTS: Out of 271 RNU cases, 143 were included with a median age of 73 (IQR 65-80). Baseline clinicopathologic features are shown in table 1. URS was performed in 104 (73%) and a ureteral access sheath was used in 26 (25%). With a median follow-up of 27 months, the bladder recurrence rate (median time to recurrence) for patients who had URS vs. not was 31.7% (9.4 months) and 7.7% (12.1 months), respectively. A lower recurrence rate was noted in patients whom a ureteral access sheath was utilized (11.5%) vs. those with no access sheath (40.3%). High grade pathology accounted for 88% of recurrences in the URS group and 67% in the no URS group. Three patients (8.3%) had muscle invasive disease on bladder recurrence, all of which were in URS group. Multivariable analysis revealed a significant increase in bladder recurrence if a URS was performed (HR 5.7, p<0.004), however, this effect was mitigated if a ureteral access sheath was used (HR 1.3, p=0.74) [Figure 1]. The type of URS and performing a biopsy had no significant effect on bladder recurrence. CONCLUSIONS: Diagnostic ureteroscopy in patients undergoing RNU for UTUC significantly increases the risk of bladder recurrence. This effect may be mitigated by using a ureteral access sheath. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e869-e869 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Antoin Douglawi More articles by this author Alireza Ghoreifi More articles by this author Ryan Lee More articles by this author Sanam Seyedian More articles by this author Jie Cai More articles by this author Gus Miranda More articles by this author Wenhao Yu More articles by this author Gerhard Fuchs More articles by this author Sumeet Bhanvadia More articles by this author Anne Schuckman More articles by this author Mihir Desai More articles by this author Siamak Daneshmand More articles by this author Monish Aron More articles by this author Rene Sotelo More articles by this author Inderbir Gill More articles by this author Hooman Djaladat More articles by this author Expand All Advertisement Loading ...

MP48-15 HOW LONG SHOULD YOU WAIT IN-BETWEEN FOLLOW-UP URETEROSCOPIES DURING CONSERVATIVE MANAGEMENT OF UPPER-TRACT UROTHELIAL CARCINOMA?

You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma II (MP48)1 Sep 2021MP48-15 HOW LONG SHOULD YOU WAIT IN-BETWEEN FOLLOW-UP URETEROSCOPIES DURING CONSERVATIVE MANAGEMENT OF UPPER-TRACT UROTHELIAL CARCINOMA? Eugenio Ventimiglia, Luca Villa, Christian Corsini, Pietro Dioni, Costantino Abbate, Olivier Traxer, Emanuele Montanari, Francesco Montorsi, and Andrea Salonia Eugenio VentimigliaEugenio Ventimiglia More articles by this author , Luca VillaLuca Villa More articles by this author , Christian CorsiniChristian Corsini More articles by this author , Pietro DioniPietro Dioni More articles by this author , Costantino AbbateCostantino Abbate More articles by this author , Olivier TraxerOlivier Traxer More articles by this author , Emanuele MontanariEmanuele Montanari 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.0000000000002074.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: It is not clear what should be the proper endoscopic follow-up strategy in patients with UTUC managed conservatively, especially in terms of timing between two consecutive flexible ureteroscopies (fURS). We aimed at the determining the best follow-up strategy, defined as the one which minimize the risk of cancer progression. METHODS: Data from 140 consecutive fURS performed for UTUC at a single academic center between 2015 and 2020 were included. fURS were performed using a digital flexible ureterorenoscope (Flex XC, Karl-Storz). Tumor Ho:YAG laser ablation was performed in any case whenever feasible (VersaPulse PowerSuite 100W, Lumenis). Patients with high grade UTUC at initial diagnostic biopsy and managed conservatively due to imperative indications were included in the analysis. For each patient, we estimated the average interval between two consecutive fURS procedures (fURSint) until last follow-up date. Multivariable Cox regression analysis estimated the association between fURSint and risk of cancer progression, accounting for patient age, tumor size and grade. We analysed the graphical association (LOWESS) between fURSint and the multivariable adjusted probability of progression-free survival, in order to identify possible non-linear trends for both low- and high-grade UTUC. RESULTS: Median (IQR) patient age and follow-up time were respectively 70 (66-79) years and 14 (6-31) months. Median (IQR) fURSint was 3.4 (2-5.6) months. Disease progression occurred in 11 (31%) patients and was classified as systemic in 4 (11%). At multivariable Cox regression analysis, longer fURSint was associated to reduced progression-free survival (HR [95% CIs] 0.32 [0.19-0.54]). A longer fURSint was more detrimental in men with high-grade UTUC, especially when it was longer than 3 months (Figure 1). CONCLUSIONS: A long fURSint should be avoided in men under endoscopic follow-up for conservative management of UTUC. In men with high-grade UTUC and imperative indications for endoscopic follow-up, fURSint longer than 3 months is associated to poor prognosis. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e870-e871 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 Christian Corsini More articles by this author Pietro Dioni More articles by this author Costantino Abbate More articles by this author Olivier Traxer More articles by this author Emanuele Montanari More articles by this author Francesco Montorsi More articles by this author Andrea Salonia More articles by this author Expand All Advertisement Loading ...

Correlation between hydronephrosis, tumor diameter, and pathologic T stage of upper tract transitional cell carcinoma after nephroureterectomy

Objective: To evaluate the correlation between hydronephrosis, tumor diameter, and pT stage of upper tract transitional cell carcinoma. Material and Method: From October 2004 to December 2018, the medical records of 98 patients in Rajavithi Hospital who were diagnosed with renal pelvic (47 patients) and ureteral (51 patients) transitional cell carcinoma and treated with nephroureterectomy were retrospectively reviewed. Patient demographics, degree of hydronephrosis, tumor diameter from computed tomography, and pathologic report were collected. Data were analyzed to determine correlations. Results: In renal pelvic tumor, higher degree of hydronephrosis correlated with higher pT stage (p=0.022) but no significant difference was shown in ureteral tumor (p=0.352). For tumor diameter in both renal pelvis and ureter, there were no correlations with pT stage (p=0.128 and p=0.625). For tumor location, higher pT stage was more common in renal pelvic tumors (p=0.001) and high tumor grade correlated with high pT stage (p=0.037). Conclusion: In this study, there was significant correlation between the preoperative degree of hydronephrosis and pT stage in renal pelvic transitional cell carcinomas; however, none was found in ureteric tumors. The reason may be that smaller ureteric lumen caused early symptoms, which concerned patients.

PT357 - A review of the accuracy of pre-operative radiological staging to identify locally advanced upper tract transitional cell carcinoma

PT357 - A review of the accuracy of pre-operative radiological staging to identify locally advanced upper tract transitional cell carcinoma

Bladder Cancer: Upper Tract Transitional Cell Carcinoma I (PD18)

You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma I (PD18)1 Apr 2020Bladder Cancer: Upper Tract Transitional Cell Carcinoma I (PD18) View All Author Informationhttps://doi.org/10.1097/JU.0000000000000861AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail &#xa9; 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Expand All Advertisement PDF downloadLoading ...

PD49-06 BENCHMARKING CURRENT NEPHRECTOMY PRACTICE IN MALIGNANT DISEASE IN ENGLAND: AN ANALYSIS OF THE BAUS COMPLEX OPERATION REGISTRY

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy V (PD49)1 Apr 2020PD49-06 BENCHMARKING CURRENT NEPHRECTOMY PRACTICE IN MALIGNANT DISEASE IN ENGLAND: AN ANALYSIS OF THE BAUS COMPLEX OPERATION REGISTRY John Pascoe*, Joseph John, Sarah Fowler, Ben Challacombe, Krishna Narahari, and John McGrath John Pascoe*John Pascoe* More articles by this author , Joseph JohnJoseph John More articles by this author , Sarah FowlerSarah Fowler More articles by this author , Ben ChallacombeBen Challacombe More articles by this author , Krishna NarahariKrishna Narahari More articles by this author , and John McGrathJohn McGrath More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000943.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urologists in England performing nephrectomy for cancer are mandated in providing public-facing outcome data as part of the ‘Consultant Outcomes Publication’. The BAUS complex operations registry is a nationally held repository, providing contemporary benchmarking data to both patients and professionals. METHODS: The BAUS registry was retrospectively reviewed for cases between 2016 and 2018. For this analysis, all patients were from England, had a non-benign diagnosis and had their exact operation recorded. There are two opportunities for surgeons to review and amend their data before lockdown and data cleansing. RESULTS: 18,369 malignant nephrectomies were recorded during this period taking place across 145 centres by 272 surgeons. Using Hospital episode statistics (HES) as the comparator, the BAUS nephrectomy dataset for England (2016-18) was deemed to be 91.3% complete. Cases were be sub-divided into three categories: radical nephrectomy (RN) (58.3%), nephroureterectomy (NU) (16.1%) & partial nephrectomy (PN) (25.6%). Each was individually analysed focussing on patient demographics, presentation, intraoperative, postoperative, surgical volume & histological variables. Overall the median patient age was 66 with 64.1% of patients being male. Preoperative diagnosis was recorded as renal mass in 84.5% & upper tract transitional cell carcinoma in 15.5%. Overall, 74.4% of PN and 50.3% RN were performed for incidental findings, whilst 66.2% of patients undergoing a NU had presented symptomatically with haematuria. Pre-operative biopsies were performed in 7.1% of RN, 39.9% of NU & 17.3% of PN. Minimally invasive surgery (MIS) was undertaken in 80.0% of cases with robotically-assisted surgery being the predominant surgical approach in PN (62.2%). Conversion to open remained rare, with a rates ranging from 3.1% in RN to 2.1% in NU & 1.79% in PN. Transfusion rate was rare at 6.3% in RN, 3.4% in NU & 2.1% in PN. Between operations there was little variation in median length of stay with 3 days in RN & PN and 4 in NU. Clear cell renal carcinoma was the most commonly reported final histology in 77% of RN & 65% of PN. TCC accounted for 84% of NU cases. Benign final histology was 3.2% (RN), 3.7% (NU) & 13.4% (PN). CONCLUSIONS: The BAUS nephrectomy dataset represents one of the largest, unselected case series capable of benchmarking surgical practice and outcomes at a national level. Individual surgeons can compare their case-mix, current surgical practice & selected outcomes with the national benchmarking comparators. With public-facing dissemination of these data, patients can also improve their knowledge of expected clinical outcomes. The data also offer an insight into changes in service provision nationally such as centralisation of surgery and adoption of novel surgical techniques. Source of Funding: No external funding provided © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1002-e1003 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information John Pascoe* More articles by this author Joseph John More articles by this author Sarah Fowler More articles by this author Ben Challacombe More articles by this author Krishna Narahari More articles by this author John McGrath More articles by this author Expand All Advertisement PDF downloadLoading ...