Complex percutaneous resections for upper-tract urothelial carcinoma.
Brian H Irwin1, Andre K Berger, Ricardo Brandina
1Steven B. Streem Center for Endourology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Journal of Endourology
|March 12, 2010
Summary
Percutaneous endoscopic resection is effective for complex upper-tract urothelial carcinoma (UC). This study found similar outcomes for complex and non-complex UC cases treated with this minimally invasive approach.
Area of Science:
- Urology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Upper-tract urothelial carcinoma (UC) presents treatment challenges, especially in complex cases.
- Percutaneous endoscopic resection is an established option for selected UC patients.
Purpose of the Study:
- To evaluate the efficacy and safety of percutaneous endoscopic resection for complex upper-tract UC.
- To compare outcomes between complex and non-complex UC cases undergoing percutaneous resection.
Main Methods:
- Retrospective review of a prospectively maintained database of patients with upper-tract UC.
- Identification of 16 complex cases based on tumor size, renal function, or anatomic variants.
- Comparison of oncologic and perioperative outcomes with 23 non-complex cases.
Main Results:
- No significant differences in complication rates, creatinine levels, or tumor characteristics between complex and non-complex groups.
- Similar recurrence-free and cancer-specific survival rates observed in both groups.
- A trend towards improved overall survival was noted in non-complex patients.
Conclusions:
- Percutaneous endoscopic resection is a viable and safe treatment for complex upper-tract UC.
- Patients with large tumors, poor renal function, or complex anatomy can benefit from this approach.
- Endoscopic treatment offers comparable oncologic outcomes to standard cases.
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