The Recurrence Rates at Three Years for the Conservatively Managed UTUC Cases Using NBI-Assisted Flexible
Petrisor Geavlete1,2, Valentin Iordache1, Razvan Multescu1,2
1Department of Urology, "St. John" Emergency Clinical Hospital, Vitan-Barzesti 13, District 4, 042122 Bucharest, Romania.
Medicina (Kaunas, Lithuania)
|January 8, 2025
Summary
Narrow Band Imaging (NBI)-assisted ureteroscopy significantly reduces recurrence rates for upper tract urothelial carcinoma (UTUC) at three years. This technique also improves cancer-specific survival compared to procedures without NBI.
Area of Science:
- Urology
- Oncology
- Medical Technology
Background:
- Upper tract urothelial carcinoma (UTUC) presents diagnostic and management challenges.
- Conservative management of UTUC is an alternative to nephroureterectomy.
- Flexible ureteroscopy with Holmium laser vaporization is a minimally invasive treatment option.
Purpose of the Study:
- To evaluate the three-year recurrence rates of UTUC managed conservatively with NBI-assisted flexible ureteroscopy and Holmium laser vaporization.
- To compare outcomes between NBI-assisted and non-NBI-assisted procedures.
- To assess the impact on cancer-specific survival.
Main Methods:
- A comparative study involving 61 patients treated with NBI-assisted flexible ureteroscopy and Holmium laser vaporization.
- A control group of 61 patients underwent the same procedure without NBI.
- Outcomes measured included recurrence rates, nephroureterectomy rates, and cancer-specific survival at three years.
Main Results:
- The one-year recurrence rate was 3.3% with NBI versus 8.2% without (p < 0.05).
- The three-year recurrence rate was 11.5% with NBI versus 18% without (p < 0.05).
- Cancer-specific survival was higher in the NBI group (93.4%) compared to the control group (86.9%) (p < 0.05).
Conclusions:
- NBI-assisted flexible ureteroscopy and Holmium laser vaporization lead to lower three-year recurrence rates for UTUC compared to non-NBI techniques.
- The use of NBI improves cancer-specific survival in patients with UTUC undergoing conservative management.
- NBI enhances visualization, aiding in more effective treatment of superficial pyelo-calyceal urothelial tumors.
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