BACKGROUND: The purpose of this study was to compare the postsurgical survival of UUT-UC patients treated with ONU and LNU. METHODS: Using a multi-institutional, national, retrospective database, we identified patients with UUT-UC who underwent radical nephroureterectomy by open access (ONU) or by the minimally invasive alternative (LNU). Survival curves were estimated using Kaplan-Meier method. A multivariate Cox model was used to evaluate the association between surgical approach and disease recurrence. RESULTS: Overall, 609 patients were included (ONU = 459 and LNU = 150). The median age was 69.8 years (range 61.9-76), and the male-to-female ratio was 2:1. Postoperative complications occurred in 80 patients, with no significant difference between ONU and LNU on the whole (P = 0.64). The median follow-up was 27 months. There was no difference between the 2 procedures in the 5-year CSS or 5-year RFS. Moreover, the 5-year CSS (P = 0.053) and 5-year RFS (P = 0.9) for cases with locally advanced disease (pT3/pT4) were similar between ONU and LNU. In the multivariate analysis, the surgical procedure used was not found to be associated with survival. The main limitation of the study is its retrospective design, which is the result of the rarity of the disease. CONCLUSIONS: There is no evidence that oncological outcomes for LNU are inferior to those for open surgery, provided that the appropriate precautionary measures are taken.
BACKGROUND: The purpose of this study was to compare the postsurgical survival of UUT-UC patients treated with ONU and LNU. METHODS: Using a multi-institutional, national, retrospective database, we identified patients with UUT-UC who underwent radical nephroureterectomy by open access (ONU) or by the minimally invasive alternative (LNU). Survival curves were estimated using Kaplan-Meier method. A multivariate Cox model was used to evaluate the association between surgical approach and disease recurrence. RESULTS: Overall, 609 patients were included (ONU = 459 and LNU = 150). The median age was 69.8 years (range 61.9-76), and the male-to-female ratio was 2:1. Postoperative complications occurred in 80 patients, with no significant difference between ONU and LNU on the whole (P = 0.64). The median follow-up was 27 months. There was no difference between the 2 procedures in the 5-year CSS or 5-year RFS. Moreover, the 5-year CSS (P = 0.053) and 5-year RFS (P = 0.9) for cases with locally advanced disease (pT3/pT4) were similar between ONU and LNU. In the multivariate analysis, the surgical procedure used was not found to be associated with survival. The main limitation of the study is its retrospective design, which is the result of the rarity of the disease. CONCLUSIONS: There is no evidence that oncological outcomes for LNU are inferior to those for open surgery, provided that the appropriate precautionary measures are taken.
Authors: Pierre Colin; Tarek P Ghoneim; Laurent Nison; Thomas Seisen; Eric Lechevallier; Xavier Cathelineau; Adil Ouzzane; Marc Zerbib; Jean-Alexandre Long; Alain Ruffion; Sébastien Crouzet; Olivier Cussenot; Marie Audouin; Jacques Irani; Solène Gardic; Pascal Gres; François Audenet; Mathieu Roumiguié; Antoine Valeri; Morgan Rouprêt Journal: World J Urol Date: 2013-06-29 Impact factor: 4.226
Authors: Vincent Trudeau; Giorgio Gandaglia; Jonas Shiffmann; Ioana Popa; Shahrokh F Shariat; Francesco Montorsi; Paul Perrotte; Quoc-Dien Trinh; Pierre I Karakiewicz; Maxine Sun Journal: Can Urol Assoc J Date: 2014-09 Impact factor: 1.862
Authors: Michael Metcalfe; Wassim Kassouf; Ricardo Rendon; David Bell; Jonathan Izawa; Joseph Chin; Anil Kapoor; Edward Matsumoto; Jean-Baptiste Lattouf; Fred Saad; Louis Lacombe; Yves Fradet; Adrian Fairey; Niels-Eric Jacobson; Darryl Drachenberg; Ilias Cagiannos; Alan So; Peter Black Journal: Can Urol Assoc J Date: 2012-12 Impact factor: 1.862