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KMID : 1001020110090020076
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Journal of Urologic Oncology
2011 Volume.9 No. 2 p.76 ~ p.81
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Impact of Diagnostic Ureteroscopy on Recurrence in Patients with Urothelial Cancer of the Upper Urinary Tract: A Matched Case-Control Study
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Kim Hong-Seok
Choi Jae-Deok
Lee Geon-Seok
So Byung-Kuk
Jeon Se-Hyun
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Abstract
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Purpose: We determined whether diagnostic ureteroscopy for urothelial cancer of the upper urinary tract affects intravesical recurrence, local recurrence, contralateral recurrence and, distant metastasis.
Materials and Methods: In matched case-control study, we evaluated 140 patients undergoing nephroureterectomy for urothelial cancer of the upper urinary tract who had no history of invasive bladder cancer, distant metastasis, preoperative chemotherapy or radiotherapy between 1995 and 2009. Of 140 patients, seventy patients underwent diagnostic ureteroscopy before nephroureterectomy(study group) and, the others did not underwent diagnostic ureteroscopy(control group). We analyzed intravesical recurrence, local recurrence, contralateral recurrence and, distant metastasis.
Results: There was no significant difference between the 2 groups in patient characteristics or upper urinary tract cancer stage and grade. During follow-up intravesical recurrence developed in 49 of 140 patients(35%) at a median of 11 months. The 2-year bladder recurrence-free survival rate was 72.2% in study group and 69.7% in control group without significant difference(Log rank p=0.7351). The 5-year local recurrence-free survival rate was 89.5% in study group and 93.9% in control group(Log rank p=0.4467). The 5-year distant metastasis-free survival rate was 85.3% in study group and 84.2% in control group(Log rank p=0.8720).
Conslusions: We consider that the diagnostic ureteroscopy did not adversely affect recurrence in patients with urothelial cancer of the upper urinary tract undergoing nephroureterectomy.
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KEYWORD
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Urothelial cancer, Ureteroscopy, Recurrence
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