Simultaneous radical cystectomy and nephroureterectomy: A case series
Gavin G Calpin1,2, Steven M Anderson1,2, Mark Broe1
1Department of Urology, Beaumont Hospital, Dublin 9, Ireland.
Surgery in Practice and Science
|March 24, 2025
Summary
Simultaneous radical cystectomy and nephroureterectomy (RCNU) is a complex procedure for urothelial carcinoma (UC) and muscle-invasive bladder cancer (MIBC). This study found RCNU effective for panurothelial cancer and MIBC with upper tract dysfunction.
Area of Science:
- Urology
- Oncology
- Surgical Oncology
Background:
- Simultaneous radical cystectomy and nephroureterectomy (RCNU) is a complex procedure indicated for specific cases of urothelial carcinoma (UC).
- Indications include multifocal high-grade UC or muscle-invasive bladder cancer (MIBC) with a compromised kidney.
Purpose of the Study:
- To review the indications, operative approaches, and outcomes of RCNU procedures.
- To evaluate the effectiveness of RCNU in patients with advanced UC and upper tract compromise.
Main Methods:
- A single-center, retrospective review of patients undergoing RCNU between 2015-2024.
- Data collected included clinicopathological features, operative details (laparoscopic vs. open), and patient outcomes.
Main Results:
- Eight male patients (mean age 66.4 years) underwent RCNU with ileal conduit. Four procedures were laparoscopic, four were open.
- High-grade UC and MIBC were common. 62.5% had T3/4 disease, 50% node-positive. Two had synchronous upper tract UC; others had obstructed kidneys.
- Mean follow-up was 31.6 months. Four recurrences and three deaths from metastatic disease occurred. Mean overall survival was 21.8 months; disease-free survival was 19.3 months.
Conclusions:
- Combined laparoscopic and open RCNU is an effective treatment strategy.
- RCNU is a viable option for patients with panurothelial cancer and MIBC involving a non-functioning upper urinary tract.
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