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Endourological Treatment of Upper Tract Urothelial Carcinomas: Analysis of a Series of 59 Tumors

1996; Lippincott Williams & Wilkins; Volume: 156; Issue: 2 Linguagem: Inglês

10.1016/s0022-5347(01)65854-3

1527-3792

J A Martínez-Piñeiro, Ma. Justa Garcia Matres, Luis Martínez‐Piñeiro,

Urinary and Genital Oncology Studies

No AccessJournal of UrologyClinical Urology: Original Article1 Aug 1996Endourological Treatment of Upper Tract Urothelial Carcinomas: Analysis of a Series of 59 Tumors Jose A. Martinez-Pineiro, Ma. Justa Garcia Matres, and Luis Martinez-Pineiro Jose A. Martinez-PineiroJose A. Martinez-Pineiro , Ma. Justa Garcia MatresMa. Justa Garcia Matres , and Luis Martinez-PineiroLuis Martinez-Pineiro View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)65854-3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We analyzed a series of 59 reno-ureteral units with upper tract urothelial carcinoma treated endourologically at our institution. Materials and Methods: Between January 1980 and January 1995, 54 of 185 patients with a clinically diagnosed upper tract tumor were considered candidates for endourological treatment. Of the patients 14 had either bilateral disease or a solitary kidney. The primary approach was ureteroscopy in 39 reno-ureteral units and percutaneous nephroscopy in 20. Superficial stage pTa, T1 or Tis disease was noted in 48 cases, infiltrating stage pT2 cancer in 4 and inverted papilloma in 4, while the tumor was impossible to classify in 3. A total of 32 patients received adjuvant supplemental therapy. Results: Ureteroscopy failed in 11 cases (28.2 percent), with salvage by nephroureterectomy in 6 and percutaneous nephroscopy in 5. Primary nephroscopy failed in 3 cases (15 percent) that were salvaged by open surgery. Two patients died of unrelated causes postoperatively and 14 (26 percent) had intraoperative or late complications that were treated conservatively in 12. After a mean followup of 30.6 months (range 2 to 119), 2 patients died of progressive upper tract tumor, 2 died of concurrent bladder cancer and 2 died of a second cancer. Of 42 upper tracts treated solely by endourological means 10 (23.8 percent) had recurrences, which were treated endourologically in 6. Bacillus Calmette-Guerin and mitomycin C seemed to be effective at preventing recurrences, with recurrence rates of 12.5 and 14.2 percent, respectively, compared to 60 percent for thiotepa, and 40 percent for oral combination 5-fluorouracil and uracil. Conclusions: Endourological treatment of low grade, small, noninvasive tumors of the upper urinary tract is a feasible and safe alternative even in patients with a normal contralateral kidney. References 1 : La ureteroscopia transuretral. Un actual proceder urologico. Arch. Esp. Urol.1980; 33: 445. Google Scholar 2 Martinez-Pineiro, J.A. and Perez Castro, E.: Endoscopic treatment of low-grade/stage ureteral tumors. Read at XIX International Congress of the Societe Internationale d'Urologie. San Francisco, California, September 5-10, 1982. 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Link, Google Scholar Urological Service, La Paz University Hospital, Faculty of Medicine, Universidad Autonoma, Madrid, Spain.© 1996 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byKrambeck A, Thompson R, Lohse C, Patterson D, Segura J, Zincke H, Elliott D and Blute M (2018) Endoscopic Management of Upper Tract Urothelial Carcinoma in Patients With a History of Bladder Urothelial CarcinomaJournal of Urology, VOL. 177, NO. 5, (1721-1726), Online publication date: 1-May-2007.Krambeck A, Thompson R, Lohse C, Patterson D, Elliott D and Blute M (2018) Imperative Indications for Conservative Management of Upper Tract Transitional Cell CarcinomaJournal of Urology, VOL. 178, NO. 3, (792-797), Online publication date: 1-Sep-2007.Akdogan B, Dogan H, Eskicorapci S, Sahin A, Erkan I and Ozen H (2018) Prognostic Significance of Bladder Tumor History and Tumor Location in Upper Tract Transitional Cell CarcinomaJournal of Urology, VOL. 176, NO. 1, (48-52), Online publication date: 1-Jul-2006.IBORRA I, SOLSONA E, CASANOVA J, RICÓS J, RUBIO J and CLIMENT M (2018) Conservative Elective Treatment of Upper Urinary Tract Tumors: A Multivariate Analysis of Prognostic Factors For Recurrence and ProgressionJournal of Urology, VOL. 169, NO. 1, (82-85), Online publication date: 1-Jan-2003.LAGUNA M and de la ROSETTE J (2018) THE ENDOSCOPIC APPROACH TO THE DISTAL URETER IN NEPHROURETERECTOMY FOR UPPER URINARY TRACT TUMORJournal of Urology, VOL. 166, NO. 6, (2017-2022), Online publication date: 1-Dec-2001.Chen G, El-Gabry E and Bagley D (2018) SURVEILLANCE OF UPPER URINARY TRACT TRANSITIONAL CELL CARCINOMA: : THE ROLE OF URETEROSCOPY, RETROGRADE PYELOGRAPHY, CYTOLOGY AND URINALYSISJournal of Urology, VOL. 164, NO. 6, (1901-1904), Online publication date: 1-Dec-2000.CHEN G and BAGLEY D (2018) URETEROSCOPIC MANAGEMENT OF UPPER TRACT TRANSITIONAL CELL CARCINOMA IN PATIENTS WITH NORMAL CONTRALATERAL KIDNEYSJournal of Urology, VOL. 164, NO. 4, (1173-1176), Online publication date: 1-Oct-2000.JABBOUR M, DESGRANDCHAMPS F, CAZIN S, TEILLAC P, LE DUC A and SMITH A (2018) PERCUTANEOUS MANAGEMENT OF GRADE II UPPER URINARY TRACT TRANSITIONAL CELL CARCINOMA: THE LONG-TERM OUTCOMEJournal of Urology, VOL. 163, NO. 4, (1105-1107), Online publication date: 1-Apr-2000.PALOU J, SALVADOR J, MILLÁN F, COLLADO A, ALGABA F and VICENTE J (2018) MANAGEMENT OF SUPERFICIAL TRANSITIONAL CELL CARCINOMA IN THE INTRAMURAL URETER: WHAT TO DO?Journal of Urology, VOL. 163, NO. 3, (744-747), Online publication date: 1-Mar-2000.CLARK P, STREEM S and GEISINGER M (2018) 13-YEAR EXPERIENCE WITH PERCUTANEOUS MANAGEMENT OF UPPER TRACT TRANSITIONAL CELL CARCINOMAJournal of Urology, VOL. 161, NO. 3, (772-776), Online publication date: 1-Mar-1999.TAKEBAYASHI S, HOSAKA M, TAKASE K, KUBOTA N, KISHIDA T and MATSUBARA S (2018) COMPUTERIZED TOMOGRAPHY NEPHROSCOPIC IMAGES OF RENAL PELVIC CARCINOMAJournal of Urology, VOL. 162, NO. 2, (315-318), Online publication date: 1-Aug-1999.Bagley D (2018) Editorial: Endourology ProgressesJournal of Urology, VOL. 157, NO. 1, (42-43), Online publication date: 1-Jan-1997.Fuchs G (2018) Editorial: A Coming of Age-Percutaneous Endopyelotomy and a Technique to Watch Out for, that is Ureteroscopic Surgery for Upper Tract Transitional Cell CarcinomaJournal of Urology, VOL. 157, NO. 5, (1620-1621), Online publication date: 1-May-1997. Volume 156Issue 2August 1996Page: 377-385 Advertisement Copyright & Permissions© 1996 by American Urological Association, Inc.MetricsAuthor Information Jose A. Martinez-Pineiro More articles by this author Ma. Justa Garcia Matres More articles by this author Luis Martinez-Pineiro More articles by this author Expand All Advertisement PDF downloadLoading ...