Risk factor analysis of intravesical recurrence after retroperitoneoscopic nephroureterectomy for upper tract urothelial carcinoma

BMC Urology

Hayato Takeda¹  Jun Akatsuka¹  Yukihiro Kondo¹  Yuki Endo¹  Masato Yanagi¹  Tsutomu Hamasaki² 

[1] Department of Urology, Nippon Medical School Hospital, 1-1-5, Sendagi, 113-8603, Bunkyo-ku, Tokyo, Japan;Department of Urology, Nippon Medical School Musashikosugi Hospital, 1-396, Kosugityo, Nakahara-ku, 211-8533, Kawasaki city, Kanagawa, Japan;

关键词: Upper urinary tract;    Urothelial carcinoma;    Retroperitoneoscopic nephroureterectomy;    Pneumoretroperitoneum time;    Intravesical recurrence;    Urine cytology;   

DOI  :  10.1186/s12894-021-00932-2

来源: Springer

【 摘 要 】

BackgroundOne of the major concerns of patients with upper tract urothelial carcinoma (UTUC) treated with nephroureterectomy is intravesical recurrence (IVR). The purpose of the present study was to investigate the predictive risk factors for IVR after retroperitoneoscopic nephroureterectomy (RNU) for UTUC.MethodsClinicopathological and surgical information were collected from the medical records of 73 patients treated with RNU for non-metastatic UTUC, without a history of or concomitant bladder cancer. The association between IVR after RNU and clinicopathological and surgery-related factors, including preoperative urine cytology and pneumoretroperitoneum time, was analyzed using the Fisher exact test.ResultsDuring the median follow-up time of 39.1 months, 18 (24.7%) patients had subsequent IVR after RNU. The 1- and 3-year IVR-free survival rates were 85.9% and 76.5%, respectively. The Fisher exact test revealed that prolonged pneumoretroperitoneum time of ≥ 210 min was a risk factor for IVR in 1 year after RNU (p = 0.0358) and positive urine cytology was a risk factor for IVR in 3 years after RNU (p = 0.0352).ConclusionsIn UTUC, the occurrences of IVR in 1 and 3 years after RNU are highly probable when the pneumoretroperitoneum time is prolonged (≥ 210 min) and in patients with positive urine cytology, respectively. Strict follow-up after RNU is more probable recommended for these patients.

【 授权许可】

CC BY