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Oncologic control obtained after exclusive flexible ureteroscopic management of upper urinary tract urothelial cell carcinoma

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Abstract

Objective

To assess oncological outcome after first-line management of upper urinary tract urothelial cell carcinomas (UUT-UCCs) by exclusive flexible ureteroscopy.

Materials and methods

A retrospective review was performed for 35 patients treated between 2003 and 2007. All patients underwent retrograde flexible ureteroscopy for diagnosis, treatment (i.e., holmium:YAG vaporisation), and follow-up. The following data were reviewed: sex, age, ASA score, presence of a solitary kidney, unifocal or multifocal tumour, history of bladder cancer, tumour localisation, tumour size, stage and grade, outcome, recurrence, and progression.

Results

The mean age was 67 ± 13.1 years (range: 38–88). The tumour involved the renal pelvis and the caliceal system in 19 cases (54%), the ureter in 8 cases (23%), and both in 8 cases (23%). Twelve patients (34%) had a history of bladder carcinoma. Tumour stage was superficial in 63% (57% were pTa and 6% were pT1) and not available in 37%. Tumour grade was low, high, and unavailable in 49, 14, and 37%, respectively. The median follow-up was 30 months (range: 12–66), and 21 patients had a recurrence (60%). The median survival rate without recurrence was 10 months (95% CI [5–22]). Four patients underwent nephroureterectomy during follow-up. No patient died of disease progression. The main limitation was the limited length of follow-up.

Conclusions

Flexible endoscopic management can be advocated in selected cases of non-muscle invasive UUT-UCCs as an alternative to nephroureterectomy. Because of a high recurrence rate, long-term and stringent surveillance is needed, including iterative ureteroscopies at least every 3 months for 2 years.

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Conflict of interest statement

There is no conflict of interest.

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Authors and Affiliations

  1. The Academic Department of Urology of Tenon and of Pitié-Salpétrière, Groupe Hospitalo-Universitaire EST, Assistance-Publique Hôpitaux de Paris; Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France

    Jean-Nicolas Cornu, Morgan Rouprêt, Xavier Carpentier, Bogdan Geavlete, Sixtina Gil Diez de Medina, Olivier Cussenot & Olivier Traxer

  2. CeRePP, Centre d’études et de Recherche sur les Pathologies Prostatiques, Université Paris VI, Paris, France

    Morgan Rouprêt & Olivier Cussenot

  3. Academic Urology Department, Hopital Tenon, 4 rue de la Chine, 75020, Paris, France

    Olivier Traxer

Authors
  1. Jean-Nicolas Cornu
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  2. Morgan Rouprêt
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  3. Xavier Carpentier
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  4. Bogdan Geavlete
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  5. Sixtina Gil Diez de Medina
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  6. Olivier Cussenot
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  7. Olivier Traxer
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Correspondence to Olivier Traxer.

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Cornu, JN., Rouprêt, M., Carpentier, X. et al. Oncologic control obtained after exclusive flexible ureteroscopic management of upper urinary tract urothelial cell carcinoma. World J Urol 28, 151–156 (2010). https://doi.org/10.1007/s00345-009-0494-x

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  • DOI: https://doi.org/10.1007/s00345-009-0494-x

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