Endourologic management of patients with upper-tract transitional-cell carcinoma: long-term follow-up in a single center.

J Endourol 2007 Sep;21(9):1005-9

Department of Urology, Western General Hospital, Edinburgh, UK.

Purpose: To evaluate the outcome of endoscopic management of upper-tract transitional-cell carcinoma (TCC).

Patients And Methods: From March 1991 to March 2006, 40 patients with upper-tract TCC were treated by an endoscopic approach as the primary management: 37 (90.2%) by ureteroscopy and by percutaneous techniques or both approaches in 2 cases each (5%). Follow-up was between 5 and 115 months (mean 41.6 months). Most of the patients, 26 (65%), had a normal contralateral kidney, and the indication for conservative management was low tumor grade or tumor size (<2 cm) and patient commitment to a rigorous follow-up protocol. Absolute and relative indications for conservative management such as solitary kidney were met in 14 patients (35%).

Results: Treatment consisted of electrocautery only in 15 cases (36.6%), neodymium:YAG or holmium:YAG laser only in 11 (26.8%), and combinations in 15 (36.6%). Most of the patients (74.3%) had an upper-tract recurrence. The renal-preservation rate was 70.7%, and the survival rate was 80%.

Conclusions: Conservative treatment is preferred in patients with bilateral disease, a solitary kidney, or co-morbidities that contraindicate major surgery. Patients with low-grade, low-stage disease and normal contralateral kidneys also benefit from this approach provided adequate endoscopic follow-up can be achieved and the surgeon has a low threshold for carrying out ablative surgery.

Download full-text PDF

Source
http://www.liebertpub.com/doi/10.1089/end.2006.9922
Publisher Site
http://dx.doi.org/10.1089/end.2006.9922DOI Listing
September 2007
2 Reads

Publication Analysis

Top Keywords

upper-tract transitional-cell
8
patients upper-tract
8
transitional-cell carcinoma
8
upper-tract tcc
4
indication conservative
4
tcc treated
4
endoscopic approach
4
kidney indication
4
treated endoscopic
4
2006 patients
4
march 2006
4
months patients
4
methods march
4
march 1991
4
1991 march
4
conservative management
4
115 months
4
primary management
4
65% normal
4
percutaneous techniques
4

Similar Publications