Literature DB >> 21354598

Perioperative outcomes of laparoscopic radical nephroureterectomy and regional lymphadenectomy in patients with upper urinary tract urothelial carcinoma after neoadjuvant chemotherapy.

M Zak Rajput1, Ashish M Kamat, Jonathan Clavell-Hernandez, Arlene O Siefker-Radtke, H Barton Grossman, Colin P N Dinney, Surena F Matin.   

Abstract

OBJECTIVES: To determine the effect of neoadjuvant chemotherapy on the surgical outcomes in patients undergoing laparoscopic radical nephroureterectomy (LNUX) for upper urinary tract urothelial carcinoma (UTUC).
METHODS: We performed a retrospective review of all patients with UTUC who had undergone LNUX at our institution from January 2003 to June 2010. We compared the differences in demographic, clinicopathologic, and operative parameters, including the estimated blood loss, duration of surgery, length of postoperative hospitalization, and number of complications, between the patients who had undergone LNUX after neoadjuvant chemotherapy and those who had undergone LNUX without neoadjuvant chemotherapy. Logistic regression analysis was performed to identify the predictors of complications.
RESULTS: We identified 82 patients with UTUC who had undergone LNUX. Of these patients, 26 had received neoadjuvant chemotherapy. The patients who had undergone LNUX after neoadjuvant chemotherapy had a greater body mass index, greater biopsy tumor grade, and longer operative time than those who had undergone LNUX without neoadjuvant chemotherapy. The patients who received neoadjuvant chemotherapy had undergone regional lymphadenectomy more often, with more lymph nodes and lymphoadipose tissue removed, than those who had not received neoadjuvant chemotherapy. Neoadjuvant chemotherapy resulted in a 15% complete remission rate. No differences in the median estimated blood loss, intraoperative transfusion rate, or length of hospitalization between the 2 groups were found. The perioperative complication rates were similar in both groups.
CONCLUSIONS: We found no differences in the surgical outcomes between those patients who had undergone LNUX after neoadjuvant chemotherapy and those who had undergone LNUX without neoadjuvant chemotherapy. Our findings support the use of LNUX for selected patients undergoing neoadjuvant chemotherapy for UTUC.
Copyright © 2011 Elsevier Inc. All rights reserved.

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Year:  2011        PMID: 21354598      PMCID: PMC3118266          DOI: 10.1016/j.urology.2011.01.002

Source DB:  PubMed          Journal:  Urology        ISSN: 0090-4295            Impact factor:   2.649


  24 in total

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3.  Laparoscopic nephroureterectomy for upper tract transitional cell cancer: the Washington University experience.

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7.  Nephroureterectomy for treating upper urinary tract transitional cell carcinoma: Time to change the treatment paradigm?

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2.  Risk stratification of metastatic recurrence in invasive upper urinary tract carcinoma after radical nephroureterectomy without lymphadenectomy.

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Review 3.  Complications Following Radical Nephroureterectomy.

Authors:  Jay D Raman; Syed M Jafri
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Review 4.  Oncologic outcomes obtained after neoadjuvant and adjuvant chemotherapy for the treatment of urothelial carcinomas of the upper urinary tract: a review.

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9.  Oncological outcomes of neoadjuvant chemotherapy in patients with locally advanced upper tract urothelial carcinoma: a multicenter study.

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Journal:  Oncotarget       Date:  2017-10-06

Review 10.  Interplay between chronic kidney disease (CKD) and upper tract urothelial carcinomas (UUC): foe or friend?

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Journal:  Oncotarget       Date:  2016-08-16
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