Chen Fang1, Xin Xie1, Tianyuan Xu1, Wei He1, Hongchao He1, Xiaojing Wang1, Yu Zhu1, Zhoujun Shen1, Yuan Shao2,3. 1. Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No. 197, 2nd Ruijin Road, Shanghai, 200025, China. 2. Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No. 197, 2nd Ruijin Road, Shanghai, 200025, China. shaoyuanrj@126.com. 3. Department of Urology, Ruijin Hospital North, Shanghai Jiaotong University School of Medicine, Shanghai, China. shaoyuanrj@126.com.
Abstract
OBJECTIVE: To evaluate oncologic outcomes of segmental ureterectomy (SU) compared with radical nephroureterectomy (RNU) for urothelial carcinoma of ureter. To evaluate whether tumor position is a factor to influence outcomes of different surgical procedures. METHODS: From November 2003 to June 2016, 131 patients with urothelial carcinoma of ureter underwent SU or RNU at our department. We used survival analysis and Cox regression models to compare oncologic outcomes after SU and RNU. Covariates included surgical type, tumor stage, cancer grade, lesion position, presence of preoperative hydronephrosis and histories of bladder cancer. Patients were divided according to lesion sites for further comparison. RESULTS: The mean length of follow-up was 55.3 and 50.9 months for the RNU and SU group, respectively. The bladder recurrences, local recurrences, distant metastasis, cancer-specific survival and overall survival rates showed no significant differences between RNU and SU (p = 0.596, p = 0.636, p = 0.740, p = 0.809, p = 0.553, respectively). For mid-ureter or distal ureter lesions, no significant difference of oncologic outcomes between SU and RUN was observed. CONCLUSIONS: Our study suggested SU is not inferior to RNU for either middle or distal ureter urothelial cell carcinomas.
OBJECTIVE: To evaluate oncologic outcomes of segmental ureterectomy (SU) compared with radical nephroureterectomy (RNU) for urothelial carcinoma of ureter. To evaluate whether tumor position is a factor to influence outcomes of different surgical procedures. METHODS: From November 2003 to June 2016, 131 patients with urothelial carcinoma of ureter underwent SU or RNU at our department. We used survival analysis and Cox regression models to compare oncologic outcomes after SU and RNU. Covariates included surgical type, tumor stage, cancer grade, lesion position, presence of preoperative hydronephrosis and histories of bladder cancer. Patients were divided according to lesion sites for further comparison. RESULTS: The mean length of follow-up was 55.3 and 50.9 months for the RNU and SU group, respectively. The bladder recurrences, local recurrences, distant metastasis, cancer-specific survival and overall survival rates showed no significant differences between RNU and SU (p = 0.596, p = 0.636, p = 0.740, p = 0.809, p = 0.553, respectively). For mid-ureter or distal ureter lesions, no significant difference of oncologic outcomes between SU and RUN was observed. CONCLUSIONS: Our study suggested SU is not inferior to RNU for either middle or distal ureter urothelial cell carcinomas.
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