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Clinical Analysis of the Predictors for Intravesical Recurrence After Laparoscopic Radical Nephroureterectomy in Japanese Patients

Received: 5 December 2019     Accepted: 9 January 2020     Published: 21 January 2020
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Abstract

Objectives: In this study, we evaluate the clinicopathological independent prognostic factors which to predict IVR in patients who underwent Laparoscopic-assisted radical nephroureterectomy (LRNU) for upper urinary tract carcinoma (UTUC). Methods: Between April 2008 to February 2019, we analyzed 100 japanese patients who were underwent LRNU and 92 patients who were underwent open radical nephroureterectomy (ORNU) at our institutions by retrospectively. The Patients characteristics factors, the clinicopathologic factors were collected. The intravesical recurrence free survival (IVRFS) were analyzed using the Kaplan-Meier method and Univariate and multivariate method by using the Cox proportional hazards regression models were performed to identify independent risk factors for IVR after LRNU. Results: In LRNU group, IVR was observed in 39 cases (39%), and it was not significant difference compare with ORNU (P: 0.36). Tumor location (P=0.002), Tumor size (P=0.001), preoperative urine cytology (P<0.0001), the pneumoperitoneum time (P: 0.0005) and adjuvant chemotherapy (P=0.019) showed significant association with postoperative IVR. In the multivariate Cox hazard models, the tumor location (P=0.0003), positive preoperative urinary cytology (P=0.003), and absence of adjuvant chemotherapy (P=0.003) were independent risk factors for subsequent IVR. There were not associated with smoking, Brinkman index, hydronephrosis and ureterorenoscopy before RNU for IVR. Overal survival (OS) was not significant association for experience IVR (P=0.15). Conclusion: In this study, LRNU was not shown to have a significantly higher IVR compared to ORNU. Patients with ureteral cancer and positive preoperative urinary cytology had a higher risk of IVR after LRNU. The adjuvant chemotherapy was significantly decreased the risk for postoperative IVR.

Published in International Journal of Clinical Urology (Volume 4, Issue 1)
DOI 10.11648/j.ijcu.20200401.12
Page(s) 6-12
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Intravesical Recurrence, Laparoscopic Nephroureterectomy, Upper tract Urothelial Carcinoma

References
[1] E. Xylinas, P. Colin, F. Audenet, et al. Intravesical recurrence after radical nephroureterectomy for upper tract urothelial carcinomas: predictors and impact on subsequent oncological outcomes from a national multicenter study, World J. Urol. 2013; 31: 61-68.
[2] E. Xylinas, L. Kluth, N. Passoni, et al. Prediction of intravesical recurrence after radical nephroureterectomy: development of a clinical decision-making tool, Eur. Urol. 2014; 65: 650-658.
[3] Thomas Seisen, Benjamin Granger, et al. A Systematic Review and Meta-analysis of Clinicopathologic Factors Linked to Intravesical Recurrence after Radical Nephroureterectomy to Treat Upper Tract Urothelial Carcinoma. Eur Urol. 2015 Jun; 67 (6): 1122-1133.
[4] V. Margulis, S. F. Shariat, S. F. Matin, et al. Outcomes of radical nephroureterectomy: a series from the upper tract urothelial carcinoma collaboration, Cancer 2009; 115: 1224-1233.
[5] Azémar MD, Comperat E,, Richard F, Cussenot O, Rouprêt M. Bladder recurrence after surgery for upper urinary tract urothelial cell carcinoma: fre- quency, risk factors, and surveillance. Urol Oncol. 2011; 29: 130-6.
[6] Chan Ho Lee, Ja Yoon Ku, Chang Wook Jeong, Ja Hyeon Ku, Predictors for Intravesical Recurrence Following Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: A National Multicenter Analysis. Clinical Genitourinary Cancer, 2017; 15: 1055-61.
[7] Tanaka N, Kikuchi E, Kanao K, et al. The predictive value of positive urine cytology for outcomes following radical nephroureterectomy in patients with primary upper tract urothelial carcinoma: a multi-institutional study. Urol Oncol 2014; 32 (48): 19-26.
[8] Kobayashi Y, Saika T, Miyaji Y, et al. Preoperative positive urine cytology is a risk factor for subsequent development of bladder cancer after nephroureterectomy in patients with upper urinary tract urothelial carcinoma. World J Urol 2012; 30: 271-5.
[9] Luo HL, Kang CH, Chen YT, et al. Diagnostic ureteroscopy independently correlates with intravesical recurrence after nephroureterectomy for upper urinary tract urothelial carcinoma. Ann Surg Oncol 2013; 20: 3121-6.
[10] Sankin A, Tin AL, Mano R, et al. Impact of ureteroscopy before nephroureterectomy for upper tract urothelial carcinoma on oncologic outcomes. Urology 2016; 94: 148-53.
[11] Fradet V, Mauermann J, Kassouf W, et al. Risk factors for bladder cancer recurrence after nephroureterectomy for upper tract urothelial tumors: results from the Canadian Upper Tract Collaboration. Urol Oncol 2014; 32: 839-45.
[12] Ku JH, Choi WS, Kwak C, Kim HH. Bladder cancer after nephroureterectomy in patients with urothelial carcinoma of the upper urinary tract. Urol Oncol 2011; 29: 383-7.
[13] Soga N, Arima K, Sugimura Y. Adjuvant methotrexate, vinblastine, adriamycin, and cisplatin chemotherapy has potential to prevent recurrence of bladder tumors after surgical removal of upper urinary tract transitional cell carcinoma. Int J Urol 2008; 15: 800-3.
[14] Keisuke Shigeta, Eiji Kikuchi, Masayuki Hagiwara, Toshiyuki Ando, Ryuichi Mizuno. Prolonged pneumoperitoneum time is an independent risk factor for intravesical recurrence after laparoscopic radical nephroureterectomy in upper tract urothelial carcinoma. Surgical Oncology 2017; 26: 73-79.
[15] V. Fradet, J. Mauermann, W. Kassouf, et al. Risk factors for bladder cancer recurrence after nephroureterectomy for upper tract urothelial tumors: results from the Canadian Upper Tract Collaboration, Urol. Oncol. 2014; 32: 839-845.
[16] L. Zou, L. Zhang, H. Zhang, H. Jiang, Q. Ding. Comparison of post-operativeintravesical recurrence and oncological outcomes after open versus laparoscopic nephroureterectomy for upper urinary tract urothelial carcinoma, World J. Urol. 2014; 32: 565-570.
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[18] Zigeuner RE, Hutterer G, Chromecki T, Rehak P, Langner C. Bladder tumour development after urothelial carcinoma of the upper urinary tract is related to primary tumour location. BJU Int 2006; 98: 1181-6.
[19] Kurzer E, Leveillee RJ, Bird VG. Combining hand assisted laparoscopic nephroureterectomy with cystoscopic circumferential excision of the distal ureter without primary closure of the bladder cuff-is it safe? J Urol 2006; 175: 63-7, discussion: 67-8.
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[22] Ito A, Shintaku I, Satoh M, et al. Prospective randomized phase II trial of a single early intravesical instillation of pirarubicin (THP) in the prevention of bladder recurrence after nephroureterectomy for upper urinary tract urothelial carcinoma: the THP Monotherapy Study Group Trial. J Clin Oncol. 2013; 31: 1422-7.
Cite This Article
  • APA Style

    Satoshi Fukata, Hideo Fukuhara, Shingo Ashida, Takashi Karashima, Keiji Inoue. (2020). Clinical Analysis of the Predictors for Intravesical Recurrence After Laparoscopic Radical Nephroureterectomy in Japanese Patients. International Journal of Clinical Urology, 4(1), 6-12. https://doi.org/10.11648/j.ijcu.20200401.12

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    ACS Style

    Satoshi Fukata; Hideo Fukuhara; Shingo Ashida; Takashi Karashima; Keiji Inoue. Clinical Analysis of the Predictors for Intravesical Recurrence After Laparoscopic Radical Nephroureterectomy in Japanese Patients. Int. J. Clin. Urol. 2020, 4(1), 6-12. doi: 10.11648/j.ijcu.20200401.12

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    AMA Style

    Satoshi Fukata, Hideo Fukuhara, Shingo Ashida, Takashi Karashima, Keiji Inoue. Clinical Analysis of the Predictors for Intravesical Recurrence After Laparoscopic Radical Nephroureterectomy in Japanese Patients. Int J Clin Urol. 2020;4(1):6-12. doi: 10.11648/j.ijcu.20200401.12

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  • @article{10.11648/j.ijcu.20200401.12,
      author = {Satoshi Fukata and Hideo Fukuhara and Shingo Ashida and Takashi Karashima and Keiji Inoue},
      title = {Clinical Analysis of the Predictors for Intravesical Recurrence After Laparoscopic Radical Nephroureterectomy in Japanese Patients},
      journal = {International Journal of Clinical Urology},
      volume = {4},
      number = {1},
      pages = {6-12},
      doi = {10.11648/j.ijcu.20200401.12},
      url = {https://doi.org/10.11648/j.ijcu.20200401.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcu.20200401.12},
      abstract = {Objectives: In this study, we evaluate the clinicopathological independent prognostic factors which to predict IVR in patients who underwent Laparoscopic-assisted radical nephroureterectomy (LRNU) for upper urinary tract carcinoma (UTUC). Methods: Between April 2008 to February 2019, we analyzed 100 japanese patients who were underwent LRNU and 92 patients who were underwent open radical nephroureterectomy (ORNU) at our institutions by retrospectively. The Patients characteristics factors, the clinicopathologic factors were collected. The intravesical recurrence free survival (IVRFS) were analyzed using the Kaplan-Meier method and Univariate and multivariate method by using the Cox proportional hazards regression models were performed to identify independent risk factors for IVR after LRNU. Results: In LRNU group, IVR was observed in 39 cases (39%), and it was not significant difference compare with ORNU (P: 0.36). Tumor location (P=0.002), Tumor size (P=0.001), preoperative urine cytology (P<0.0001), the pneumoperitoneum time (P: 0.0005) and adjuvant chemotherapy (P=0.019) showed significant association with postoperative IVR. In the multivariate Cox hazard models, the tumor location (P=0.0003), positive preoperative urinary cytology (P=0.003), and absence of adjuvant chemotherapy (P=0.003) were independent risk factors for subsequent IVR. There were not associated with smoking, Brinkman index, hydronephrosis and ureterorenoscopy before RNU for IVR. Overal survival (OS) was not significant association for experience IVR (P=0.15). Conclusion: In this study, LRNU was not shown to have a significantly higher IVR compared to ORNU. Patients with ureteral cancer and positive preoperative urinary cytology had a higher risk of IVR after LRNU. The adjuvant chemotherapy was significantly decreased the risk for postoperative IVR.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Clinical Analysis of the Predictors for Intravesical Recurrence After Laparoscopic Radical Nephroureterectomy in Japanese Patients
    AU  - Satoshi Fukata
    AU  - Hideo Fukuhara
    AU  - Shingo Ashida
    AU  - Takashi Karashima
    AU  - Keiji Inoue
    Y1  - 2020/01/21
    PY  - 2020
    N1  - https://doi.org/10.11648/j.ijcu.20200401.12
    DO  - 10.11648/j.ijcu.20200401.12
    T2  - International Journal of Clinical Urology
    JF  - International Journal of Clinical Urology
    JO  - International Journal of Clinical Urology
    SP  - 6
    EP  - 12
    PB  - Science Publishing Group
    SN  - 2640-1355
    UR  - https://doi.org/10.11648/j.ijcu.20200401.12
    AB  - Objectives: In this study, we evaluate the clinicopathological independent prognostic factors which to predict IVR in patients who underwent Laparoscopic-assisted radical nephroureterectomy (LRNU) for upper urinary tract carcinoma (UTUC). Methods: Between April 2008 to February 2019, we analyzed 100 japanese patients who were underwent LRNU and 92 patients who were underwent open radical nephroureterectomy (ORNU) at our institutions by retrospectively. The Patients characteristics factors, the clinicopathologic factors were collected. The intravesical recurrence free survival (IVRFS) were analyzed using the Kaplan-Meier method and Univariate and multivariate method by using the Cox proportional hazards regression models were performed to identify independent risk factors for IVR after LRNU. Results: In LRNU group, IVR was observed in 39 cases (39%), and it was not significant difference compare with ORNU (P: 0.36). Tumor location (P=0.002), Tumor size (P=0.001), preoperative urine cytology (P<0.0001), the pneumoperitoneum time (P: 0.0005) and adjuvant chemotherapy (P=0.019) showed significant association with postoperative IVR. In the multivariate Cox hazard models, the tumor location (P=0.0003), positive preoperative urinary cytology (P=0.003), and absence of adjuvant chemotherapy (P=0.003) were independent risk factors for subsequent IVR. There were not associated with smoking, Brinkman index, hydronephrosis and ureterorenoscopy before RNU for IVR. Overal survival (OS) was not significant association for experience IVR (P=0.15). Conclusion: In this study, LRNU was not shown to have a significantly higher IVR compared to ORNU. Patients with ureteral cancer and positive preoperative urinary cytology had a higher risk of IVR after LRNU. The adjuvant chemotherapy was significantly decreased the risk for postoperative IVR.
    VL  - 4
    IS  - 1
    ER  - 

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Author Information
  • Department of Urology, Kochi University School of Medicine, Nankoku, Kochi, Japan

  • Department of Urology, Kochi University School of Medicine, Nankoku, Kochi, Japan

  • Department of Urology, Kochi University School of Medicine, Nankoku, Kochi, Japan

  • Department of Urology, Kochi University School of Medicine, Nankoku, Kochi, Japan

  • Department of Urology, Kochi University School of Medicine, Nankoku, Kochi, Japan

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