Endoscopic management of upper tract urothelial cancer in a highly endemic area: A Taiwan nationwide collaborative study

Yung Tai Chen, Hsin Chih Yeh, Hsiang Ying Lee, Po Fan Hsieh, Eric Chieh lung Chou, Yao Chou Tsai, Jian Hua Hong, Chao Yuan Huang, Yuan Hong Jiang, Yu Khun Lee, Jen Shu Tseng, Chih Chin Yu, Bing Juin Chiang, Thomas Y. Hsueh, Chia Chang Wu, Chung You Tsai

研究成果: 雜誌貢獻文章同行評審

2 引文 斯高帕斯(Scopus)

摘要

Background: Endoscopic management of upper tract urothelial cancer (UTUC) is an important treatment option for low risk UTUC. Although Taiwan is an endemic area for UTUC, endoscopic treatment outcomes in Taiwan are frequently under- reported. Methods: This study retrospectively reviewed the treatment outcomes of endoscopic management for clinically localized UTUC. Patients with biopsy or washing cytology confirmed UTUC who underwent endoscopic or percutaneous management with a curative intent were retrospectively reviewed for eligibility of analysis. Those cases without pre-intervention confirmed UTUC, and metastatic or nodal disease at diagnosis were excluded. Results: In total, 307 patients who underwent endoscopic management were reviewed and 279 cases were eligible for final analysis. With a median follow-up of 44.3 months (inter-quartile range (IQR): 23.4–76.4 months), 117 cases (46.4%) were endoscopic cured after median one session (range:1–8; IQR:1–2) of endoscopic treatment. Those endoscopic cured UTUC was associated with more small-sized tumor, more low-grade biopsied-histology, less concomitant bladder UC and less pre-operative hydronephrosis. In addition, 201(79.7%) cases among 252 cases with confirmed oncological outcome were free of UTUC at the end of follow-up and only 43 (17%) patients had a UTUC related mortality. Salvage RNU offered a better tumor free survival rate (92% vs. 77.5%) than those without salvage RNU in those UTUC refractory to endoscopic management. In multivariable analyses, pre-operative hydronephrosis was the independent risk factor for OS. Multiplicity and concomitant bladder UC were independent risk factors for DFS. Conclusions: We confirmed the consistent safety and efficacy of endoscopic management of clinical localized UTUC in a highly UTUC endemic area like Taiwan. Early salvage RNU is mandatory in those UTUC refractory to endoscopic management in prevention of UTUC related death.
原文英語
頁(從 - 到)3058-3065
頁數8
期刊Asian Journal of Surgery
46
發行號8
DOIs
出版狀態接受/付印 - 2022

ASJC Scopus subject areas

  • 手術

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