Abstract | PURPOSE: To assess long-term oncologic outcomes in patients with renal pelvic cancer who are receiving nephrectomy plus endoscopy-assisted intussusception ureterectomy. There has been no large study reporting long-term oncologic outcomes of this approach in comparison with those of conventional nephroureterectomy plus bladder cuff removal. PATIENTS AND METHODS: RESULTS: Patients in the intussusception group had larger tumor size, higher histologic grade, and more advanced pathologic stage (P = 0.005, 0.021, and 0.030, respectively), while the incidence of coexistent bladder/ ureteral cancer was lower in this group (P < 0.001). The mean operative time was shorter in the intussusception group than in the cuff removal and orifice-remaining groups (201.2 ± 33.1 and 221.5 ± 47.2 min, respectively, P < 0.001). The 5-year extraurinary tract recurrence-free survival rate in the intussusception and cuff removal groups was 74.8% and 71.4%, respectively (log-rank P = 0.766), and it was lower in the orifice-remaining group compared with that in the intussusception group (P = 0.031). The 5-year urinary tract recurrence-free survival rate in the intussusception, cuff removal, and orifice-remaining groups was 76.6%, 65.0%, and 65.0%, respectively ( intussusception vs cuff removal: P = 0.089). With both univariate and multivariate analyses, intussusception ureterectomy had no significant impact on urinary tract recurrence (multivariate P = 0.553, hazard ratio = 0.784). CONCLUSIONS:
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Authors | Noboru Hara, Yasuo Kitamura, Toshihiro Saito, Shunji Wakatsuki, Yasunosuke Sakata, Shuichi Komatsubara |
Journal | Journal of endourology
(J Endourol)
Vol. 25
Issue 4
Pg. 691-7
(Apr 2011)
ISSN: 1557-900X [Electronic] United States |
PMID | 21434766
(Publication Type: Clinical Trial, Comparative Study, Journal Article)
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Topics |
- Aged
- Demography
- Disease-Free Survival
- Endoscopy
(adverse effects)
- Female
- Humans
- Intussusception
(complications, surgery)
- Kidney Neoplasms
(complications, surgery)
- Kidney Pelvis
(pathology, surgery)
- Male
- Middle Aged
- Multivariate Analysis
- Nephrectomy
(adverse effects, methods)
- Perioperative Care
- Postoperative Complications
(etiology)
- Recurrence
- Treatment Outcome
- Ureter
(surgery)
- Urinary Bladder
(surgery)
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