Skip to main content
Journal cover image

Predictive factors for applicability and success with endoscopic treatment of upper tract urothelial carcinoma.

Publication ,  Journal Article
Suh, RS; Faerber, GJ; Wolf, JS
Published in: J Urol
December 2003

PURPOSE: We report on endoscopic treatment outcomes for upper tract urothelial carcinoma and identify predictive factors for success. MATERIALS AND METHODS: A total of 61 renal units were referred for endoscopic treatment of an upper tract tumor, 69% of which did not have a traditional indication for nephron sparing approaches. Tumor pathology and operative findings were assessed retrospectively for treatment outcomes and influential factors. RESULTS: Initial ureteroscopic inspection was undertaken in 53 renal units with resection attempted in 18 (34%) resulting in an 89% success rate with 16 treated. A percutaneous approach in 19 renal units (11 after ureteroscopy) was 100% successful in achieving tumor-free status, for a total of 35 renal units successfully treated endoscopically. Surveillance then began on 27 renal units with a recurrence rate of 88% and mean time to recurrence of 5.8 months (range 2 to 20). Of patients undergoing surveillance (31% of whom had high grade disease), 54% remain or have died of unrelated disease, during a mean followup of 21.0 months (range 3 to 48). Higher tumor grade, larger size, renal pelvis location (all p <0.01) and multifocality (p = 0.05) significantly correlated with decreased recurrence-free survival, but did not predict failure of local control by endoscopic surveillance. CONCLUSIONS: Although endoscopic techniques can render most patients tumor-free, there is a high associated recurrence rate and many need repeat procedures. Recurrence-free survival is greater in patients with low grade, solitary or less bulky disease. However, rigorous surveillance after endoscopic resection can lead to success even in patients with high grade, multifocal or large volume disease, resulting in preservation of renal units.

Duke Scholars

Published In

J Urol

DOI

ISSN

0022-5347

Publication Date

December 2003

Volume

170

Issue

6 Pt 1

Start / End Page

2209 / 2216

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Ureteroscopy
  • Ureteral Neoplasms
  • Survival Rate
  • Retrospective Studies
  • Prognosis
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Male
  • Kidney Neoplasms
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Suh, R. S., Faerber, G. J., & Wolf, J. S. (2003). Predictive factors for applicability and success with endoscopic treatment of upper tract urothelial carcinoma. J Urol, 170(6 Pt 1), 2209–2216. https://doi.org/10.1097/01.ju.0000097327.20188.c1
Suh, Ronald S., Gary J. Faerber, and J Stuart Wolf. “Predictive factors for applicability and success with endoscopic treatment of upper tract urothelial carcinoma.J Urol 170, no. 6 Pt 1 (December 2003): 2209–16. https://doi.org/10.1097/01.ju.0000097327.20188.c1.
Suh, Ronald S., et al. “Predictive factors for applicability and success with endoscopic treatment of upper tract urothelial carcinoma.J Urol, vol. 170, no. 6 Pt 1, Dec. 2003, pp. 2209–16. Pubmed, doi:10.1097/01.ju.0000097327.20188.c1.
Journal cover image

Published In

J Urol

DOI

ISSN

0022-5347

Publication Date

December 2003

Volume

170

Issue

6 Pt 1

Start / End Page

2209 / 2216

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Ureteroscopy
  • Ureteral Neoplasms
  • Survival Rate
  • Retrospective Studies
  • Prognosis
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Male
  • Kidney Neoplasms