Impact of Diagnostic Ureteroscopy on Intravesical Recurrence and Survival in Patients With Urothelial Carcinoma of the Upper Urinary Tract
Impact of Diagnostic Ureteroscopy on Intravesical Recurrence and Survival in Patients With Urothelial Carcinoma of the Upper Urinary Tract
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DOI：
10.1016/j.juro.2010.05.027
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发表时间：
2010-09-01
影响因子：
6.6
通讯作者：
Nonomura, Katsuya
中科院分区：
文献类型：
--
作者：
Ishikawa, Shuhei;Abe, Takashige;Nonomura, Katsuya
目的：我们确定是否诊断性输尿管镜检查上尿路cancer.Materials和方法膀胱内复发和癌症特异性mortality的影响：在一项回顾性的，多机构的研究，我们评估了208例接受肾输尿管切除术的上尿路癌谁没有围手术期全身化疗，浸润性膀胱癌，远处转移或不完整的随访数据。在这208名患者中，55名患者在肾输尿管切除术前接受了诊断性输尿管镜检查，而153名患者作为对照组没有接受诊断性输尿管镜检查。我们分析了膀胱内复发和癌症的特异性生存使用Kaplan-Meier方法与对数秩检验用于评估significant.Results：有两组患者的特征或上尿路癌的阶段和级别，而随访无显着差异，多个肿瘤和淋巴血管浸润阳性肿瘤的比例显着更大的控制。2年膀胱无复发生存率研究组为60.0%，对照组为58.7%。两组间膀胱内复发率无显著差异（对数秩检验p = 0.972）。估计Kaplan-Meier癌症特异性生存率分别为88.3%和78.1%，在5年的研究和对照组，分别（对数秩检验p = 0.0687）。结论：诊断性输尿管镜检查并不影响膀胱内复发或肿瘤特异性生存的患者接受肾输尿管切除术的上尿路癌。
Purpose: We determined whether diagnostic ureteroscopy for upper urinary tract cancer affects intravesical recurrence and cancer specific mortality.Materials and Methods: In a retrospective, multi-institutional study we evaluated 208 patients undergoing nephroureterectomy for upper urinary tract cancer who had no perioperative systemic chemotherapy, history of invasive bladder cancer, distant metastasis or incomplete followup data. Of these 208 patients 55 who composed the study group underwent diagnostic ureteroscopy before nephroureterectomy while 153 serving as controls did not. We analyzed intravesical recurrence and cancer specific survival using the Kaplan-Meier method with the log rank test used to assess significance.Results: There was no significant difference between the 2 groups in patient characteristics or upper urinary tract cancer stage and grade while followup, and the proportion of multiple tumors and lymphovascular invasion positive tumors were significantly greater in controls. The 2-year bladder recurrence-free survival rate was 60.0% in the study group and 58.7% in controls. There was no significant difference in the intravesical recurrence rate between the 2 groups (log rank test p = 0.972). Estimated Kaplan-Meier cancer specific survival was 88.3% and 78.1% at 5 years in the study and control groups, respectively (log rank test p = 0.0687).Conclusions: Diagnostic ureteroscopy did not affect intravesical recurrence or cancer specific survival in patients with upper urinary tract cancer undergoing nephroureterectomy.