Outcomes of laparoscopic, robotic and open nephroureterectomy with bladder cuff excision in patients with T3T4 upper urinary tract urothelial carcinoma: a multi-center retrospective study

Jen Kai Fang, Hsin Chih Yeh, Hsiang Ying Lee, Han Yu Weng, Ta Yao Tai, Chao Yuan Huang, Jian Hua Hong, Chih Chin Yu, Shu Yu Wu, Shiu Dong Chung, Chung You Tsai, Thomas Y. Hsueh, Allen W. Chiu, Yuan Hong Jiang, Yu Khun, Lee, I. Hsuan Alan Chen, Jen Tai Lin, Yung Tai Chen, Chang Min LinIan Seng Cheong, Hsu Che Huang, Shih Hsiu Lo, Wei Yu Lin, Jen Shu Tseng, Chia Chang Wu, Shian Shiang Wang, Yi Huei Chang, Chao Hsiang Chang

研究成果: 雜誌貢獻文章同行評審

摘要

Background: Nephroureterectomy with bladder cuff excision is the standard treatment for high-risk upper urinary tract urothelial carcinoma (UTUC). The role of minimally invasive surgery in treating locally advanced UTUC remains controversial. This study aimed to compare the outcomes of open, laparoscopic, and robotic surgeries for managing locally advanced UTUC. Methods: We retrospectively reviewed 705 patients with locally advanced UTUC from multiple institutions throughout Taiwan. Perioperative outcomes and oncological outcomes, such as cancer-specific survival, overall survival, disease-free survival and bladder-free survival, were compared between the open, laparoscopic and robotic groups. Results: The minimally invasive group had better overall and cancer-specific survival (CSS) rates. The 2-year CSS rates of the open, laparoscopic and robotic groups were 71%, 83%, and 77% respectively (p < 0.001). The robotic group had similar outcomes to the laparoscopic group. (p = 0.061, 0.825, 0.341 for OS, CSS, DFS respectively.) More lymph node dissections were performed and more lymph nodes were harvested in the robotic group (p = 0.009). Conclusions: Our results demonstrated that minimally invasive surgery, including laparoscopic and robotic surgery, for locally advanced UTUC resulted in oncological outcomes that are non-inferior to those of open surgery.
原文英語
文章編號231
期刊BMC Urology
24
發行號1
DOIs
出版狀態已發佈 - 12月 2024

ASJC Scopus subject areas

  • 生殖醫學
  • 泌尿科學

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