OBJECTIVE: Conservative treatment (CT) with flexible ureteroscopy and laser ablation is an alternative to radical nephroureterectomy (RNU) for the treatment of the upper urinary tract urothelial carcinoma (UTUC).
The purpose of this study was to compare the pathology results obtained after immediate RNU or after attempt of CT for elective indication.
PATIENTS AND METHODS: A retrospective study was conducted in a single tertiary centre. All patients who had a RNU for urothelial carcinoma between 2007 and 2012 have been included. The patients were classified into two groups: Group 1 is immediate RNU and group 2 is RNU after CT (only elective indications). Preoperative data collected were: age, sex, chronic kidney failure, radiological TNM, tumor size, localization, multifocal and indication of CT. The pathological RNU data collected were: tumor stage and grade. The T stage was divided into 2 groups (Primary endpoint): pTa-T1-T2 and pT3-T4. The χ2 test and Mann-Whitney was performed to compare the independent qualitative and quantitative variables, respectively.
RESULTS: A total of 51 patients were included (40 patients in the immediate RNU group and 11 patients in the delayed RNU group after CT). Patients in both groups had comparable characteristics regarding age, sex, location, T stage and preoperative tumor grade. On final pathology, 23 tumors were classified pTa-T1-T2 in the immediate RNU group compared to 6 in the delayed RNU group. Seventeen and 5 tumors were classified T3-in group 1 and group 2, respectively. These results were not significantly different between both groups (p = 0.866). The pathological RNU grade was not significantly different between the groups.
CONCLUSION: Within the limits of this retrospective study, the pathological RNU data showed no significant difference when RNU is done immediately or after CT for UTUC.
Written by:
Haddad M, Cloutier J, Cornu JN, Villa L, Terrasa JB, Benbouzid S, Audouin M, Cussenot O, Traxer O. Are you the author?
Tenon Hospital, Urology, Paris, France.
Reference: J Endourol. 2015 Apr 15. Epub ahead of print.
doi: 10.1089/end.2015.0044
PubMed Abstract
PMID: 25873006