Hongli Shan1, Xiaoqing Wang2, Qingnian Sun3, Qihui Chen4, Bo Xu4, Yuanyuan Hao4, Wei Xu5. 1. Department of Clinical Laboratory, The First Hospital of Jilin University, Changchun, Jilin, P.R. China. 2. Department of Urology, General Hospital of Jinlin Oil Field, Songyuan, P.R. China. Electronic address: upw018@126.com. 3. Department of Urology, The First Hospital of Jilin University, Changchun, Jilin, P.R. China. 4. Department of Urology, General Hospital of Jinlin Oil Field, Songyuan, P.R. China. 5. Department of Clinical Laboratory, The First Hospital of Jilin University, Changchun, Jilin, P.R. China. Electronic address: xuwei0210@sina.com.
Abstract
BACKGROUND: The present study was designed to compare oncologic outcomes of T2 upper tract urothelial carcinoma patients treated with retroperitoneoscopic nephroureterectomy (RNU) or open radical nephroureterectomy (ONU). PATIENTS AND METHODS: T2 upper tract urothelial carcinoma patients were treated with RNU (n = 110) or ONU (n = 118) and followed-up for > 5 years. Demographic and clinical data, including preoperative indexes, intraoperative indexes, and oncological outcomes, were retrospectively compared to determine the efficacy of the 2 procedures. RESULTS: The RNU and ONU groups were statistically similar in age, sex, tumor location, and tumor pathologic grade. The original surgery time required for RNU and ONU was statistically similar, but RNU was associated with a significantly smaller volume of intraoperative estimated blood loss and shorter length of postoperative hospital stay. Follow-up (average: 43.2 months; range, 6-72 months) revealed that the estimated 5-year overall survival rate and the estimated 5-year disease-specific survival rate after RNU was slightly worse than after ONU (66.0% vs. 67.1%, and 80.8% vs. 83.8%, respectively), and the estimated 5-year recurrence-free survival rate and the estimated 5-year intravesical recurrence-free survival rates were slightly better than ONU (79.5% vs. 77.9%, and 68.3% vs. 65.6%, respectively). However, none of these differences were statistically significant. CONCLUSION: The open surgery strategy and the RNU strategy are equally effective for treating T2 upper tract urothelial carcinoma. However, the RNU procedure is safer, less invasive, and requires a shorter duration of postoperative hospitalized care; thus, RNU is recommended as the preferred strategy.
BACKGROUND: The present study was designed to compare oncologic outcomes of T2 upper tract urothelial carcinomapatients treated with retroperitoneoscopic nephroureterectomy (RNU) or open radical nephroureterectomy (ONU). PATIENTS AND METHODS: T2 upper tract urothelial carcinomapatients were treated with RNU (n = 110) or ONU (n = 118) and followed-up for > 5 years. Demographic and clinical data, including preoperative indexes, intraoperative indexes, and oncological outcomes, were retrospectively compared to determine the efficacy of the 2 procedures. RESULTS: The RNU and ONU groups were statistically similar in age, sex, tumor location, and tumor pathologic grade. The original surgery time required for RNU and ONU was statistically similar, but RNU was associated with a significantly smaller volume of intraoperative estimated blood loss and shorter length of postoperative hospital stay. Follow-up (average: 43.2 months; range, 6-72 months) revealed that the estimated 5-year overall survival rate and the estimated 5-year disease-specific survival rate after RNU was slightly worse than after ONU (66.0% vs. 67.1%, and 80.8% vs. 83.8%, respectively), and the estimated 5-year recurrence-free survival rate and the estimated 5-year intravesical recurrence-free survival rates were slightly better than ONU (79.5% vs. 77.9%, and 68.3% vs. 65.6%, respectively). However, none of these differences were statistically significant. CONCLUSION: The open surgery strategy and the RNU strategy are equally effective for treating T2 upper tract urothelial carcinoma. However, the RNU procedure is safer, less invasive, and requires a shorter duration of postoperative hospitalized care; thus, RNU is recommended as the preferred strategy.