scholarly journals Lymphadenectomy for Upper Tract Urothelial Carcinoma: A Systematic Review

2019 ◽  
Vol 8 (8) ◽  
pp. 1190 ◽  
Author(s):  
Igor Duquesne ◽  
Idir Ouzaid ◽  
Yohann Loriot ◽  
Marco Moschini ◽  
Evanguelos Xylinas
Keyword(s):  
Urinary Tract ◽  
Urothelial Carcinoma ◽  
Lymphatic Drainage ◽  
Therapeutic Benefit ◽  
Upper Urinary Tract ◽  
Recurrence Rates ◽  
Poor Prognostic Factor ◽  
Impact On Survival ◽  
Urinary Tract Urothelial Carcinoma

Background: The role of lymphonodal dissection during surgery for a tumor of the urinary tract remains controversial. Objective: To analyze anatomical bases of lymphonodal dissection in tumors of the upper urinary tract and analyze its impact on survival, recurrence, and staging. Acquisition of data: A web-based search for scientific articles using Medline/Pubmed was carried out to identify and analyze articles on the practice and the role of lymphonodal dissection in this indication. Data Synthesis: The lymphatic drainage of the upper urinary tract has rarely been studied and is poorly understood. The lymphonodal metastatic extension is the most common extension in upper urinary tract urothelial carcinoma. Lymphnode invasion is a clear independent poor prognostic factor. Therefore, it seems legitimate to offer an extended lymphonodal dissection to patients undergoing surgery to cure these tumors. When lymphnodes dissection respects clear anatomical principles based on the location of the primary tumor and its extension, it improves both survival and recurrence rates. This result could be secondary to the treatment of subclinical metastatic disease. Conclusion: An extended lymphadenectomy during surgery for upper urinary tract urothelial carcinoma following strict anatomical pattern improves staging with a highly probable therapeutic benefit.

The Role of p53 on Survival of Upper Urinary Tract Urothelial Carcinoma: A Systematic Review and Meta-Analysis

2013 ◽  
Vol 11 (3) ◽  
pp. 221-228 ◽  
Author(s):  
Ja Hyeon Ku ◽  
Seok-Soo Byun ◽  
Hyeon Jeong ◽  
Cheol Kwak ◽  
Hyeon Hoe Kim ◽  
...  
Keyword(s):  
Systematic Review ◽  
Urinary Tract ◽  
Urothelial Carcinoma ◽  
Meta Analysis ◽  
Upper Urinary Tract ◽  
Urinary Tract Urothelial Carcinoma

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.

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