(1) Background: We assessed the impact of diagnostic ureteroscopy (URS) on intravesical recurrence (IVR) following radical nephroureterectomy (RNU) for upper tract urothelial carcinoma according to the type of URS. (2) Methods: Data on 491 consecutive patients who underwent RNU at two institutions between 2016 and 2019 were retrospectively reviewed. The study population was classified according to the type of URS performed before RNU as follows: non-URS, rigid URS, and flexible URS. The study outcome was IVR occurring within 1 year of RNU. Univariable and multivariable Cox proportional hazards models were used to estimate the risk of IVR. (3) Results: Altogether, 396 patients were included for analysis. Rigid and flexible URS were performed in 178 (45%) and 111 (28%) patients, respectively, while 107 (27%) patients did not undergo URS. IVR was identified in 99 (25%) patients. Multivariable Cox regression analysis revealed that the flexible URS group was significantly associated with increased IVR, compared to the non-URS group (HR = 1.807, p = 0.0416). No significant difference in IVR was observed between the non-URS and rigid URS groups (HR = 1.301, p = 0.3388). (4) Conclusions: In patients with UTUC undergoing RNU, rigid URS may not increase the risk of IVR, whereas flexible URS appears to be associated with a higher risk of IVR.
Cancers. 2022 Nov 16*** epublish ***
Jee Soo Ha, Jinhyung Jeon, Jong Cheol Ko, Hye Sun Lee, Juyeon Yang, Daeho Kim, June Seok Kim, Won Sik Ham, Young Deuk Choi, Kang Su Cho
Department of Urology, Prostate Cancer Center, Urological Science Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea., Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul 03722, Republic of Korea., Department of Urology, Urological Science Institute, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.