Oncological and renal outcomes of segmental ureterectomy vs. radical nephroureterectomy for upper tract urothelial carcinoma

Kato,Tomonori; Nakayama,Ryo; Haba,Tomomi; Kawaguchi,Makoto; Komiya,Akira; Koike,Hiroshi

doi:10.3892/ol.2018.9463

Oncological and renal outcomes of segmental ureterectomy vs. radical nephroureterectomy for upper tract urothelial carcinoma

Authors:
- Tomonori Kato
- Ryo Nakayama
- Tomomi Haba
- Makoto Kawaguchi
- Akira Komiya
- Hiroshi Koike
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Affiliations: Division of Urology, Niigata Rosai Hospital, Japan Organization of Occupational Health and Safety, Joetsu, Niigata 942‑8502, Japan, Division of Diagnostic Pathology, Niigata Rosai Hospital, Japan Organization of Occupational Health and Safety, Joetsu, Niigata 942‑8502, Japan, Department of Urology, Chiba University Graduate School of Medicine, Chiba, Chiba 260‑8670, Japan
Published online on: September 19, 2018 https://doi.org/10.3892/ol.2018.9463
Pages: 6861-6867

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Abstract

Segmental ureterectomy (SU) represents a promising alternative for the treatment of upper tract urothelial carcinomas (UTUCs) as it is a less invasive procedure and guarantees the preservation of renal units. The present study evaluated oncological outcomes and renal functions following SU when compared with radical nephroureterectomy (RNU). A total of 26 patients with UTUCs who underwent SU (n=12) or RNU (n=14) were retrospectively evaluated. SU was performed in patients with clinically unifocal disease. In the SU group, the following surgeries were carried out: 7 direct ureterocystoneostomy, 1 reimplantation on psoas hitch bladder, 1 reimplantation on Boari flap bladder, 2 ureteral end‑to‑end anastomosis and 1 subtotal ureterectomy. In the SU group, tumors were low grade urothelial carcinoma (UC) in 6 patients, high grade UC in 5 patients and high grade UC with squamous cell differentiation in 1 patient, as well as ≤pT1 in 5, ≥pT2 in 6 and pTis in 1 patient; 'p' refers to the pathological state. The 5‑year overall, cancer‑specific, recurrence free and metastasis free survival in the SU group were 77.8, 87.5, 34.4 and 80.8%, respectively, which all exhibited no significant differences when compared with those of the RNU group. With regard to renal function, postoperative estimated glomerular filtration rates were preserved in the SU group. The present study demonstrated that SU does not result in poorer cancer control when compared with RNU. Thus, SU is an acceptable alternative to RNU in selected cases, as it is less invasive and preserves renal functions.

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