Correlation Between the Timing of Diagnostic Ureteroscopy and Intravesical Recurrence in Upper Tract Urothelial Cancer
Correlation Between the Timing of Diagnostic Ureteroscopy and Intravesical Recurrence in Upper Tract Urothelial Cancer
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DOI：
10.1016/j.clgc.2015.07.008
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发表时间：
2016-02-01
影响因子：
3.2
通讯作者：
Lee, Sang Eun
中科院分区：
文献类型：
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作者：
Lee, Jung Keun;Kim, Ki Bom;Lee, Sang Eun
为了确定诊断性输尿管镜检查对膀胱内复发的影响，我们分析了104例行根治性肾输尿管切除术的患者。膀胱内复发34例（32.6%），平均37个月。多因素Cox模型分析显示诊断性输尿管镜术后延迟肾输尿管切除术是膀胱内复发的独立预测因素。背景：本研究的目的是评估诊断性输尿管镜检查（URS）的时机相对于根治性肾输尿管切除术（RNU）对膀胱内复发（IVR）的影响。患者和方法：我们回顾性评估了2003年3月至2012年12月在一个三级转诊中心接受RNU治疗上尿路上皮癌（UTUC）的104例患者。所有患者根据诊断性尿潴留的时间进行分组：无尿潴留组（30例，无尿潴留），一期组（33例，诊断性尿潴留后立即进行RNU），二期组（41例，诊断性尿潴留后中位时间5天进行RNU）。我们使用Kaplan-Meier和Cox比例回归方法分析无ivr生存率。结果：104例患者中，34例（32.6%）在平均间隔7.2个月后发生IVR。Kaplan-Meier曲线显示，2会话组的IVR率显著高于其他组（P = 0.004）。单因素分析显示，与无URS组相比，1疗程组对IVR无影响（风险比[HR]， 95%可信区间[CI] 1.58; 0.517-4.833）。然而，2疗程组的IVR患者数量明显多于无URS组（HR, 3.82; 95% CI 1.438-10.131）。多变量Cox比例分析显示，2疗程组是UTUC患者IVR的独立预测因子（HR, 3.61; 95% CI 1.039-12.557）。结论：UTUC患者诊断URS后延迟RNU显著增加了IVR的风险。(C) 2016 Elsevier Inc.版权所有。
To identify the effects of diagnostic ureteroscopy on intravesical recurrence, 104 patients who had undergone radical nephroureterectomy were analyzed. The number of patients with intravesical recurrence was 34 (32.6%) at a mean of 37 months. Multivariate Cox model analysis revealed that delayed nephroureterectomy after diagnostic ureteroscopy were independent predictive factors for intravesical recurrence.Background: The purpose of this study was to evaluate the effects of the timing of diagnostic ureteroscopy (URS) relative to radical nephroureterectomy (RNU) on intravesical recurrence (IVR). Patients and Methods: We retrospectively evaluated 104 patients who had undergone RNU for upper tract urothelial cancer (UTUC) at a single tertiary referral center between March 2003 and December 2012. All patients were divided depending on the timing of diagnostic URS: the no URS group (30 patients, no URS), 1-session group (33 patients, diagnostic URS immediately followed by RNU), and 2-session group (41 patients, RNU after diagnostic URS at a median time of 5 days). We analyzed for IVR-free survival using the Kaplan-Meier and Cox proportional regression methods. Results: Of the 104 patients, 34 (32.6%) developed subsequent IVR at a mean interval of 7.2 months. The Kaplan-Meier curve showed that the IVR rate was significantly greater in the 2-session group than in the other groups (P = .004). Univariate analysis indicated no effect on IVR in the 1-session group compared with the no URS group (hazard ratio [HR], 95% confidence interval [CI] 1.58; 0.517-4.833). However, the 2-session group had a significantly greater number of patients with IVR than the no URS group (HR, 3.82; 95% CI 1.438-10.131). Multivariate Cox proportional analysis revealed that the 2-session group was an independent predictor of IVR in UTUC patients (HR, 3.61; 95% CI 1.039-12.557). Conclusion: Delay of RNU after diagnostic URS significantly increased the risk of IVR in UTUC patients. (C) 2016 Elsevier Inc. All rights reserved.