Reply letter to: Breda, A., Territo, A. & Sanguedolce, F. Combination of holmium and thulium laser ablation in upper tract urothelial carcinoma. World J Urol (2020). https://doi.org/10.1007/s00345-020-03124-z

2020 ◽  
Author(s):  
Lorenzo Defidio ◽  
Michele Antonucci ◽  
Anup Patel
Keyword(s):  
Laser Ablation ◽  
Urothelial Carcinoma ◽  
Upper Tract Urothelial Carcinoma ◽  
Thulium Laser ◽  
Upper Tract

Combination of holmium and thulium laser ablation in upper tract urothelial carcinoma

2020 ◽  
Vol 38 (10) ◽  
pp. 2661-2662 ◽  
Author(s):  
Alberto Breda ◽  
Angelo Territo ◽  
Francesco Sanguedolce
Keyword(s):  
Laser Ablation ◽  
Urothelial Carcinoma ◽  
Upper Tract Urothelial Carcinoma ◽  
Thulium Laser ◽  
Upper Tract

scholarly journals Endoscopic Treatment of Upper Tract Urothelial Carcinoma: Challenging the Definition of the Maximal Lesion Size for Safe Ablation

Uro ◽  
2022 ◽  
Vol 2 (1) ◽  
pp. 13-20
Author(s):  
Yazeed Barghouthy ◽  
Mariela Corrales ◽  
Alba Sierra ◽  
Hatem Kamkoum ◽  
Camilla Capretti ◽  
...  
Keyword(s):  
Laser Ablation ◽  
Urothelial Carcinoma ◽  
Endoscopic Treatment ◽  
Laser Energy ◽  
Lesion Size ◽  
Upper Tract Urothelial Carcinoma ◽  
Endoscopic Management ◽  
Upper Tract ◽  
Upper Limit ◽  
Endoscopic Ablation

Introduction: With advances in endoscopic treatment of upper tract urothelial carcinoma (UTUC) lesions, the recommended upper limit of lesion size amenable to laser ablation was set to 2 cm. However, this limit is based on expert opinion only, and debate still exists regarding this definition. Objective: To determine the maximal size of the tissue, for which total endoscopic ablation with laser energy is achievable, from a laser performance perspective. Materials and Methods: Simulating endoscopic surgery conditions, renal tissue blocks from pork kidneys in growing size from 1 cm3 to 3 cm3 were totally ablated with Ho:YAG laser (1 J, 10 Hz). The time to ablation was recorded for each tissue mass. Following the ablation, each sample was inspected microscopically by an expert pathologist to determine the extent to which the tissue was destroyed. Results: Time to ablation ranged from 16.4 min for a 1 cm3 mass, to 69.7 min for a 3 cm3 mass. Histologic evaluation after laser ablation showed that ablation was achieved in all tissue masses, and no “unaffected” tissue was present, even for lesions with a size of 3 cm3. Conclusions: This study showed that laser ablation can be achieved for tumor lesions up to a size of 3 cm3. The results of this study can contribute to the debate regarding the limits of endoscopic management of UTUC lesions and strengthen the recommended upper limit of 2 cm3 for endoscopic treatment of tumor lesions.

PD35-04 URETEROSCOPIC LASER ABLATION OF LARGE (> 2 CM) UPPER TRACT UROTHELIAL CARCINOMA

2014 ◽  
Vol 191 (4S) ◽  
Author(s):  
Nir Kleinmann ◽  
Scott G. Hubosky ◽  
Kelly A. Healy ◽  
Marluce Bibbo ◽  
Demetrius H. Bagley
Keyword(s):  
Laser Ablation ◽  
Urothelial Carcinoma ◽  
Upper Tract Urothelial Carcinoma ◽  
Upper Tract

Developing a nomogram for predicting intravesical recurrence after radical nephroureterectomy: a retrospective cohort study of mainland Chinese patients

2021 ◽  
Author(s):  
Shicong Lai ◽  
Xingbo Long ◽  
Pengjie Wu ◽  
Jianyong Liu ◽  
Samuel Seery ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Cox Regression ◽  
Upper Tract Urothelial Carcinoma ◽  
Chinese Patients ◽  
Clinicopathological Parameters ◽  
Radical Nephroureterectomy ◽  
Ki 67 ◽  
Data Set ◽  
Mainland Chinese ◽  
Upper Tract

Abstract Objective To evaluate the role of Ki-67 in predicting subsequent intravesical recurrence following radical nephroureterectomy and to develop a predictive nomogram for upper tract urothelial carcinoma patients. Methods This retrospective analysis involved 489 upper tract urothelial carcinoma patients who underwent radical nephroureterectomy with bladder cuff excision. The data set was randomly split into a training cohort of 293 patients and a validation cohort of 196 patients. Immunohistochemical analysis was used to assess the immunoreactivity of the biomarker Ki-67 in the tumor tissues. A multivariable Cox regression model was utilized to identify independent intravesical recurrence predictors after radical nephroureterectomy before constructing a nomographic model. Predictive accuracy was quantified using time-dependent receiver operating characteristic curve. Decision curve analysis was performed to evaluate the clinical benefit of models. Results With a median follow-up of 54 months, intravesical recurrence developed in 28.2% of this sample (n = 137). Tumor location, multifocality, pathological T stage, surgical approach, bladder cancer history and Ki-67 expression levels were independently associated with intravesical recurrence (all P < 0.05). The full model, which intercalated Ki-67 with traditional clinicopathological parameters, outperformed both the basic model and Xylinas’ model in terms of discriminative capacity (all P < 0.05). Decision-making analysis suggests that the more comprehensive model can also improve patients’ net benefit. Conclusions This new model, which intercalates the Ki-67 biomarker with traditional clinicopathological factors, appears to be more sensitive than nomograms previously tested across mainland Chinese populations. The findings suggest that Ki-67 could be useful for determining risk-stratified surveillance protocols following radical nephroureterectomy and in generating an individualized strategy based around intravesical recurrence predictions.

Sign in / Sign up

Export Citation Format

Share Document