scholarly journals Radical Nephroureterectomy: A Clinical Image

2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Mohammed M ◽  
◽  
Dieudonné ZOJ ◽  
Jaafar M ◽  
Soufiane E ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Prognostic Factors ◽  
Gold Standard ◽  
Upper Urinary Tract ◽  
Lumbar Pain ◽  
Clinical Image ◽  
Radical Nephroureterectomy ◽  
Left Adrenal Gland ◽  
Computed Tomography Scanner ◽  
Urinary Tract Urothelial Carcinoma

Upper Urinary Tract Urothelial Carcinoma (UTUC) remain rare. Radical Nephroureterectomy (RNU) is the Gold standard for management of these tumours. We are reporting a clinical image of a 45-year-old patient admitted in emergency for left lumbar pain (nephritic colic). The checkups requested computed tomography scanner showed a nephromegaly and left hydronephrosis upstream of a suspicious parietal thickening of the lumbar ureter with cortical and functional repercussion, neighborhood infiltration, and atypical lateral-aortic ganglia. Left lower calicial lithiasis of stasis, pancreatic nodular lesion and the left adrenal gland. The patient was a candidate for an open Radical Left Nephroureterectomy (RNU) (Figure 1). Figure 1: Radical Nephroureterectomy (RNU) picture U (Ureter) R (Renal). There are prognostic factors of tumors of the upper urinary excretory tract, which are the patient’s status, the preoperative, the operation and the anatomopathology [1]. According to current literature data, the oncology outcomes of radical nephrouretrectomy by laparoscopic are lower than those of open RNU surgery [2].

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 Combination of pembrolizumab and BCG treatment after endoscopic ablation of high-risk superficial upper urinary tract urothelial carcinoma in patients not candidates for radical nephroureterectomy: protocol for phase-II study

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e027066
Author(s):  
Marcus L Jamil ◽  
Mustafa Deebajah ◽  
Akshay Sood ◽  
Shaheen Alanee
Keyword(s):  
Urinary Tract ◽  
High Risk ◽  
Urothelial Carcinoma ◽  
Phase Ii ◽  
Upper Urinary Tract ◽  
Fixed Dose ◽  
Radical Nephroureterectomy ◽  
Safety And Efficacy ◽  
Muscle Invasive ◽  
Urinary Tract Urothelial Carcinoma

IntroductionThe treatment standard for high-risk upper urinary tract urothelial carcinoma (UUTUC) is radical nephroureterectomy. However, some patients may be unfit or unwilling, and in such patients the available alternatives are suboptimal. Therapies targeting the programmed death (PD) pathway have shown promise in urothelial carcinom (UC). We designed the current study to determine the safety and efficacy of administering MK-3475 (a monoclonal antibody targeting interaction between PD-1 and its ligand) in combination with bacillus Calmette-Guerin (BCG) in high-risk non-muscle invasive UUTUC patients.MethodsThis represents a single-centre phase-II efficacy study of MK-3475 therapy in combination with BCG for subjects, 18 years of age or older, with pathologically documented non-muscle invasive high-risk UUTUC unfit or unwilling to be treated with radical nephroureterectomy. Twenty subjects will be enrolled; patients will receive treatment with 200 mg of MK-3475 every 21 days, starting 2 weeks from the initial endoscopic resection and continuing for 6 weeks after the final dose of BCG. The primary objective is to determine the safety and efficacy of administering MK-3475 at a fixed dose of 200 mg every 3 weeks in conjunction with intrapelvic BCG. Secondary objectives include 19 week and the 3, 12 and 24-month post-treatment completion complete response and progression-free rate assessments.Ethics and disseminationThe study has been approved by the Institutional Review Board of the Henry Ford Hospital. The results of this study will be published in a peer-reviewed journal and presented at a scientific conference.Trial registration numberNCT03345134

scholarly journals Ureteral Involvement and Diabetes Increase the Risk of Subsequent Bladder Recurrence after Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Che-Yuan Hu ◽  
Yu-Chieh Tsai ◽  
Shuo-Meng Wang ◽  
Chao-Yuan Huang ◽  
Huai-Ching Tai ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Urinary Tract ◽  
Urothelial Carcinoma ◽  
Cox Model ◽  
Medical Center ◽  
Upper Urinary Tract ◽  
Increased Risk ◽  
The Impact ◽  
Bladder Recurrence ◽  
Urinary Tract Urothelial Carcinoma

Objectives.To investigate the prognostic factors for bladder recurrence after radical nephroureterectomy (RNU) in patients with upper urinary tract urothelial carcinoma (UUT-UC).Methods.From 1994 to 2012, 695 patients with UUT-UC treated with RNU were enrolled in National Taiwan University Medical Center. Among them, 532 patients with no prior bladder UC history were recruited for analysis. We assessed the impact of potentially prognostic factors on bladder recurrence after RNU.Results.The median follow-up period was 47.8 months. In the Cox model, ureteral involvement and diabetes mellitus (DM) were significantly associated with a higher bladder recurrence rate in the multivariate analysis (hazard ratio [HR]: 1.838;P=0.003and HR: 1.821;P=0.010, resp.). In the Kaplan-Meier analysis, DM patients with concomitant ureteral UC experienced about a threefold increased risk of bladder recurrence as compared to those without both factors (HR: 3.222;P<0.001). Patients with either of the two risk factors experienced about a twofold increased risk as compared to those without both factors (with DM, HR: 2.184,P=0.024; with ureteral involvement, HR: 2.006,P=0.003).Conclusions.Ureteral involvement and DM are significantly related to bladder recurrence after RNU in patients with UUT-UC.

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