Laparoscopic Radical Nephroureterectomy for Upper Tract Transitional Cell Carcinoma: Oncological Outcomes at 7 Years

Andre Berger, Georges Pascal Haber, Kazumi Kamoi, Monish Aron, Mihir M. Desai, Jihad H. Kaouk, Inderbir S. Gill

Research output: Contribution to journalArticle

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Abstract

Purpose: We present long-term oncological outcomes following laparoscopic nephroureterectomy for upper tract transitional cell carcinoma. Materials and Methods: Between December 1997 and August 2005, 100 patients underwent laparoscopic nephroureterectomy for upper tract transitional cell carcinoma at our institution. Data were obtained from a prospectively maintained database, patient charts, telephone followup and a review of the Social Security Death Index. Results: Median patient age at surgery was 73 years. Final pathological stage was pTis/pTa in 28% of patients, pT1 in 31%, pT2 in 13%, pT3 in 24% and pT4 in 4%. High grade lesions were present in 58% of patients, multifocal disease was present in 23% and lymphovascular invasion was present in 9%. Positive surgical margins occurred in 7 patients (7%). Median followup was 7 years (range 2 to 10). At 2, 5 and 7 years overall survival was 81%, 59% and 50%, cancer specific survival was 91%, 77% and 72%, and recurrence-free survival was 66%, 50% and 36%, respectively. Five-year cancer specific survival by stage was 80% for pTis/Ta, 70% for pT1, 68% for pT2, 60% for pT3 and 0% for pT4. On univariate analysis nonorgan confined disease and lymphovascular invasion affected cancer specific survival (p = 0.01 and 0.04, respectively). On multivariate analysis only nonorgan confined disease was a significant factor (p = 0.04). Concomitant bladder tumor at diagnosis was associated with poor recurrence-free survival on univariate and multivariate analysis (p = 0.02 and 0.01, respectively). Conclusions: To our knowledge the largest long-term followup after laparoscopic nephroureterectomy for upper tract transitional cell carcinoma is presented. Long-term oncological outcomes appear comparable to those of open surgery.

Original languageEnglish (US)
Pages (from-to)849-854
Number of pages6
JournalJournal of Urology
Volume180
Issue number3
DOIs
StatePublished - Sep 2008
Externally publishedYes

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Transitional Cell Carcinoma
Survival
Multivariate Analysis
Recurrence
Neoplasms
Social Security
Telephone
Urinary Bladder Neoplasms
Databases

Keywords

  • carcinoma
  • kidney
  • laparoscopy
  • nephrectomy
  • outcome assessment (health care)
  • transitional cell

ASJC Scopus subject areas

  • Urology

Cite this

Berger, A., Haber, G. P., Kamoi, K., Aron, M., Desai, M. M., Kaouk, J. H., & Gill, I. S. (2008). Laparoscopic Radical Nephroureterectomy for Upper Tract Transitional Cell Carcinoma: Oncological Outcomes at 7 Years. Journal of Urology, 180(3), 849-854. https://doi.org/10.1016/j.juro.2008.05.042

Laparoscopic Radical Nephroureterectomy for Upper Tract Transitional Cell Carcinoma : Oncological Outcomes at 7 Years. / Berger, Andre; Haber, Georges Pascal; Kamoi, Kazumi; Aron, Monish; Desai, Mihir M.; Kaouk, Jihad H.; Gill, Inderbir S.

In: Journal of Urology, Vol. 180, No. 3, 09.2008, p. 849-854.

Research output: Contribution to journalArticle

Berger, Andre ; Haber, Georges Pascal ; Kamoi, Kazumi ; Aron, Monish ; Desai, Mihir M. ; Kaouk, Jihad H. ; Gill, Inderbir S. / Laparoscopic Radical Nephroureterectomy for Upper Tract Transitional Cell Carcinoma : Oncological Outcomes at 7 Years. In: Journal of Urology. 2008 ; Vol. 180, No. 3. pp. 849-854.
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abstract = "Purpose: We present long-term oncological outcomes following laparoscopic nephroureterectomy for upper tract transitional cell carcinoma. Materials and Methods: Between December 1997 and August 2005, 100 patients underwent laparoscopic nephroureterectomy for upper tract transitional cell carcinoma at our institution. Data were obtained from a prospectively maintained database, patient charts, telephone followup and a review of the Social Security Death Index. Results: Median patient age at surgery was 73 years. Final pathological stage was pTis/pTa in 28{\%} of patients, pT1 in 31{\%}, pT2 in 13{\%}, pT3 in 24{\%} and pT4 in 4{\%}. High grade lesions were present in 58{\%} of patients, multifocal disease was present in 23{\%} and lymphovascular invasion was present in 9{\%}. Positive surgical margins occurred in 7 patients (7{\%}). Median followup was 7 years (range 2 to 10). At 2, 5 and 7 years overall survival was 81{\%}, 59{\%} and 50{\%}, cancer specific survival was 91{\%}, 77{\%} and 72{\%}, and recurrence-free survival was 66{\%}, 50{\%} and 36{\%}, respectively. Five-year cancer specific survival by stage was 80{\%} for pTis/Ta, 70{\%} for pT1, 68{\%} for pT2, 60{\%} for pT3 and 0{\%} for pT4. On univariate analysis nonorgan confined disease and lymphovascular invasion affected cancer specific survival (p = 0.01 and 0.04, respectively). On multivariate analysis only nonorgan confined disease was a significant factor (p = 0.04). Concomitant bladder tumor at diagnosis was associated with poor recurrence-free survival on univariate and multivariate analysis (p = 0.02 and 0.01, respectively). Conclusions: To our knowledge the largest long-term followup after laparoscopic nephroureterectomy for upper tract transitional cell carcinoma is presented. Long-term oncological outcomes appear comparable to those of open surgery.",
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AB - Purpose: We present long-term oncological outcomes following laparoscopic nephroureterectomy for upper tract transitional cell carcinoma. Materials and Methods: Between December 1997 and August 2005, 100 patients underwent laparoscopic nephroureterectomy for upper tract transitional cell carcinoma at our institution. Data were obtained from a prospectively maintained database, patient charts, telephone followup and a review of the Social Security Death Index. Results: Median patient age at surgery was 73 years. Final pathological stage was pTis/pTa in 28% of patients, pT1 in 31%, pT2 in 13%, pT3 in 24% and pT4 in 4%. High grade lesions were present in 58% of patients, multifocal disease was present in 23% and lymphovascular invasion was present in 9%. Positive surgical margins occurred in 7 patients (7%). Median followup was 7 years (range 2 to 10). At 2, 5 and 7 years overall survival was 81%, 59% and 50%, cancer specific survival was 91%, 77% and 72%, and recurrence-free survival was 66%, 50% and 36%, respectively. Five-year cancer specific survival by stage was 80% for pTis/Ta, 70% for pT1, 68% for pT2, 60% for pT3 and 0% for pT4. On univariate analysis nonorgan confined disease and lymphovascular invasion affected cancer specific survival (p = 0.01 and 0.04, respectively). On multivariate analysis only nonorgan confined disease was a significant factor (p = 0.04). Concomitant bladder tumor at diagnosis was associated with poor recurrence-free survival on univariate and multivariate analysis (p = 0.02 and 0.01, respectively). Conclusions: To our knowledge the largest long-term followup after laparoscopic nephroureterectomy for upper tract transitional cell carcinoma is presented. Long-term oncological outcomes appear comparable to those of open surgery.

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