Category: Clinical Oncology: Outcomes & Complications
Introduction & Objective :
For diagnosis of upper urinary tract urothelial carcinoma, ureteroscopy is commonly used for tissue proof. Intraluminal tumor seeding is the major concern during ureteroscopy. However, heterogenous result about the role of preoperative ureteroscopy on intravesical recurrence after radical nephroureterectomy.
From 2005 to 2015, there were 828 patients with upper urinary tract urothelial carcinoma treated by radical nephroureterectomy. Patients with previous bladder cancer history were excluded. Finally, there were 604 patients with localized upper urinary tract urothelial carcinoma included in this study. Our institutional follow up protocol is fibercystoscopy every 3 months within two years. Intravesical recurrence related to preoperative ureteroscopy was identified as recurrence within two years.
There were 201 patients with preoperative ureteroscopy and 403 patients without preoperative ureteroscopy before radical nephroureterectomy in our cohort. The perioperative parameters were equal between this two groups. Kaplan Meier analysis revealed significant more intravesical recurrences (p=0.026). The curve is divided after postoperative half year.
Preoperative ureteroscopy was associated with higher intravesical recurrences after radical nephroureterectomy. Preventive intravesical chemotherapy might be considered to improve oncological outcome.
Kaohsiung Chang Gung Medical Center
Kaohsiung, Kaohsiung, Taiwan (Republic of China)