Matched-Pair Analysis of Open versus Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Cell Carcinoma

2014 ◽  
Vol 94 (2) ◽  
pp. 156-162 ◽  
Author(s):  
James P. Blackmur ◽  
Grant D. Stewart ◽  
Eric A. Egong ◽  
Mark L. Cutress ◽  
David A. Tolley ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Cell Carcinoma ◽  
Upper Urinary Tract ◽  
Matched Pair ◽  
Urothelial Cell Carcinoma ◽  
Free Survival ◽  
Matched Pair Analysis ◽  
Significant Difference ◽  
Pair Analysis ◽  
Laparoscopic Nephroureterectomy

Objective: Laparoscopic nephroureterectomy (LNU) offers a superior morbidity profile compared with open nephroureterectomy (ONU) in treating upper urinary tract urothelial cell carcinoma. Evidence of oncological equivalence between LNU and ONU is limited. We compare operative and oncological outcomes for LNU and ONU using matched-pair analysis. Methods: Of 159 patients who underwent a nephroureterectomy at a single institution between April 1992 and April 2010, 13 pairs of ONU and LNU patients were matched for gender, age, tumour location, tumour grade and stage. Operative details, post-operative characteristics and recurrences were collated and survival rates analysed using the Kaplan-Meier method. Results: There was no significant difference in mean operation time between LNU (191 min) and ONU (194 min, p = 0.92). There was no significant difference in the 5-year survival rate between LNU and ONU (overall survival 59.1% vs. 73.5%, p = 0.18; progression-free survival 24.0% vs. 56.0%, p = 0.14; cancer-specific survival 60.9% vs. 73.5%, p = 0.56; bladder cancer recurrence-free survival 8.7% vs. 0.0%, p = 0.09). Conclusion: Amidst limited RCT and comparative studies, this study presents further evidence of oncological equivalence between LNU and ONU. There was a trend towards poorer outcomes following LNU though, which merits further study.

Long-Term Comparative Outcomes of Open Versus Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial-Cell Carcinoma After a Median Follow-Up of 13 Years

2011 ◽  
Vol 25 (8) ◽  
pp. 1329-1335 ◽  
Author(s):  
Grant D. Stewart ◽  
Katie J. Humphries ◽  
Mark L. Cutress ◽  
Antony C.P. Riddick ◽  
S. Alan McNeill ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Cell Carcinoma ◽  
Upper Urinary Tract ◽  
Urothelial Cell ◽  
Urothelial Cell Carcinoma ◽  
Open Versus ◽  
Laparoscopic Nephroureterectomy

scholarly journals Matched-Pair Analysis of Survival in the Patients with Advanced Laryngeal and Hypopharyngeal Squamous Cell Carcinoma Treated with Induction Chemotherapy Plus Chemo-Radiation or Total Laryngectomy

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1735
Author(s):  
Patricia García-Cabo ◽  
Fernando López ◽  
Mario Sánchez-Canteli ◽  
Laura Fernández-Vañes ◽  
César Álvarez-Marcos ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Induction Chemotherapy ◽  
Squamous Cell ◽  
Organ Preservation ◽  
Matched Pair ◽  
Primary Tumors ◽  
Free Survival ◽  
Tumor Node Metastasis Stage ◽  
Significant Difference

Background: We performed a comparative analysis between an organ-preservation protocol and surgery followed by radiotherapy in patients with locally advanced squamous cell carcinoma of the larynx and hypopharynx; Methods: 60 previously untreated patients who were treated with induction chemotherapy followed by chemoradiotherapy in responders were compared with a control group of 60 patients treated with up-front surgery. Both groups were statistically comparable, according to the subsite, TNM (tumor-node-metastasis) stage, age, and sex; Results: Mean age was 58 years and 92% were male. No significant statistical difference was observed for overall survival (OS) (HR 0.75; 95% CI 0.48–1,18; P = 0.22) and disease-specific survival (DSS) (HR 0.98; 95% CI 0.52–1.83, P = 0.96). Also, there was no significant difference for recurrence-free survival (HR 0.931; 95% CI 0.57–1.71; P = 0.81), metastases-free survival (HR 2.23; 95% CI 0.67–7.41; P = 0.19), and the appearance of second primary tumors (HR 1.22; 95% CI 0.51–2.88; P = 0.64); Conclusions: The results of the organ-preservation approach did not appear inferior to those of surgery plus (chemo)radiotherapy for patients with T3/T4a larynx and T2–T4a hypopharynx cancer with respect to OS and DSS, locoregional control and metastases-free survival.

scholarly journals Comparison of oncologic and functional outcomes between radical nephroureterectomy and segmental ureterectomy for upper urinary tract urothelial carcinoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tae Heon Kim ◽  
Chung Un Lee ◽  
Minyong Kang ◽  
Hwang Gyun Jeon ◽  
Byong Chang Jeong ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urothelial Carcinoma ◽  
Functional Outcomes ◽  
Upper Urinary Tract ◽  
Rank Test ◽  
Radical Nephroureterectomy ◽  
Free Survival ◽  
Significant Difference ◽  
Segmental Ureterectomy ◽  
Urinary Tract Urothelial Carcinoma

AbstractThis study aims to compare oncologic and functional outcomes after radical nephroureterectomy (RNU) and segmental ureterectomy (SU) in patients with upper urinary tract urothelial carcinoma (UTUC). We retrospectively collected data on patients who underwent either RNU or SU of UTUC. Propensity score matching was performed among 394 cases to yield a final cohort of 40 RNU and 40 SU cases. Kaplan–Meier analysis and the log-rank test were used to compare overall survival (OS), cancer-specific survival (CSS), progression-free survival (PFS), and intravesical recurrence-free survival (IVRFS) between the groups. We also compared the change in postoperative estimated glomerular filtration rate (eGFR). There was no significant difference in terms of CSS, PFS, and IVRFS between the RNU and SU groups, but the RNU group had a better OS than the SU group (p = 0.032). Postoperative eGFR was better preserved in the SU group than in the RNU group (p < 0.001). SU provides comparable CSS, PFS, and IVRFS for patients with UTUC compared to RNU, even in patients with advanced-stage and/or high-grade cancer. Further, SU achieves better preservation of renal function.

scholarly journals Long-term results of retroperitoneoscopic nephroureterectomy for upper urinary tract transitional cell carcinoma in China

2013 ◽  
Vol 7 (5-6) ◽  
pp. 287 ◽  
Author(s):  
Xiao-Qing Wang ◽  
Feng-Ming Jiang ◽  
Qi-Hui Chen ◽  
Yu-Chuan Hou ◽  
Hai-Feng Zhang ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Survival Rate ◽  
Transitional Cell Carcinoma ◽  
Cell Carcinoma ◽  
Clinical Outcomes ◽  
Transitional Cell ◽  
Upper Urinary Tract ◽  
Free Survival ◽  
Node Metastasis

Objective: We compared long-term clinical outcomes of upperurinary tract transitional cell carcinoma (TCC) patients treated byretroperitoneoscopic nephroureterectomy (RNU) or open radicalnephroureterectomy (ONU).Methods: Upper urinary tract TCC patients were treated with RNU(n = 86) or ONU (n = 72) and followed-up for more than threeyears. Demographic and clinical data, including preoperativeindexes, intraoperative indexes and long-term clinical outcomes,were retrospectively compared to determine long-term efficacy ofthe two procedures.Results: The RNU and ONU groups were statistically similar inage, gender, previous bladder cancer history, tumour location,pathologic tumour stage, pathologic node metastasis or tumourpathologic grade. The original surgery time required for both RNUand ONU was statistically similar, but RNU was associated witha significantly smaller volume of intraoperative estimated bloodloss and shorter length of postoperative hospital stay. Follow-up(average: 42.4 months, range: 3-57) revealed that the RNU 3-yearrecurrence-free survival rate was 62.8% and the 3-year cancerspecific survival rate was 80.7%. In the ONU group, the 3-yearrecurrence-free survival and the three-year cancer-specific survivalrates were 59.2% and 80.3%, respectively. Neither of the survivalrates were statistically different between the two groups. T stage,grade, lymph node metastasis and bladder tumour history wererisk factors for tumour recurrence; the operation mode and thebladder cuff incision mode had no correlation with the recurrencefreesurvival.Conclusion: The open surgery strategy and the retroperitoneoscopicnephroureterectomy strategy are equally effective for treating upperurinary tract TCC. However, the RNU procedure is less invasive,and requires a shorter duration of postoperative hospitalized care;thus, RNU is recommended as the preferred strategy.

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