Complex percutaneous resections for upper-tract urothelial carcinoma

Brian H. Irwin, Andre K. Berger, Ricardo Brandina, Robert Stein, Mihir M. Desai

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background and purpose: Percutaneous endoscopic resection is a viable treatment option for upper-tract urothelial carcinoma (UC) in selected patients. We present our experience with patients who underwent percutaneous resections for complex urothelial tumors. Patients and Methods: Patients who were undergoing percutaneous treatment for UC were identified within a prospectively maintained database at a single institution. Charts were reviewed to identify complex patients (n=16) who met the following criteria: (a) tumor size >2.5cm (n=8), (b) preoperative creatinine level >3.0mg/dL (n=3), or (c) anatomic variant (cystectomy/urinary diversion [n=2]; autotransplanted kidney [n=1]; ipsilateral partial nephrectomy [n=1]; distal ureterectomy [n=1]). Demographic, operative, and oncologic data were captured. Recurrence-free, cancer-specific, and overall survivals were calculated and compared with a control group of noncomplex cases (n=23). Results: No difference was found in mean age (69.7±10.8 years vs 69.8±11.2 years), complication rate (6.3% vs 7.1%), or change in creatinine level (1.53mg/dL to 1.51mg/dL vs 1.88mg/dL to 1.57mg/dL) between noncomplex and complex cases. The incidences of high-grade tumors (55% vs 71%), invasive tumors (15% vs 20%), solitary kidney (82% vs 92%), contralateral nephroureterectomy (52% vs 60%), and history of bladder cancers (47% vs 38%) were similar between the two groups. Median follow-up was 36 months. No difference was seen in cancer-specific survival (P=0.98) or recurrence-free survival (P=0.39). An improved trend in overall survival (P=0.20) was seen in the noncomplex patients when compared with the complex group. Conclusions: These findings suggest that patients with large tumors, poor renal function, and significant anatomic variations may be well served by endoscopic treatment for upper-tract UC when indicated.

Original languageEnglish (US)
Pages (from-to)367-370
Number of pages4
JournalJournal of Endourology
Volume24
Issue number3
DOIs
StatePublished - Mar 1 2010
Externally publishedYes

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Carcinoma
Neoplasms
Survival
Kidney
Creatinine
Anatomic Variation
Recurrence
Urinary Diversion
Cystectomy
Nephrectomy
Urinary Bladder Neoplasms
Therapeutics
Demography
Databases
Control Groups
Incidence

ASJC Scopus subject areas

  • Urology

Cite this

Irwin, B. H., Berger, A. K., Brandina, R., Stein, R., & Desai, M. M. (2010). Complex percutaneous resections for upper-tract urothelial carcinoma. Journal of Endourology, 24(3), 367-370. https://doi.org/10.1089/end.2009.0181

Complex percutaneous resections for upper-tract urothelial carcinoma. / Irwin, Brian H.; Berger, Andre K.; Brandina, Ricardo; Stein, Robert; Desai, Mihir M.

In: Journal of Endourology, Vol. 24, No. 3, 01.03.2010, p. 367-370.

Research output: Contribution to journalArticle

Irwin, BH, Berger, AK, Brandina, R, Stein, R & Desai, MM 2010, 'Complex percutaneous resections for upper-tract urothelial carcinoma', Journal of Endourology, vol. 24, no. 3, pp. 367-370. https://doi.org/10.1089/end.2009.0181
Irwin, Brian H. ; Berger, Andre K. ; Brandina, Ricardo ; Stein, Robert ; Desai, Mihir M. / Complex percutaneous resections for upper-tract urothelial carcinoma. In: Journal of Endourology. 2010 ; Vol. 24, No. 3. pp. 367-370.
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