Intermediate-term outcomes of robot-assisted laparoscopic nephroureterectomy in upper urinary tract urothelial carcinoma

Sey Kiat Lim, Tae Young Shin, Kwang Hyun Kim, Byungha Chung, Sung Joon Hong, Youngdeuk Choi, KoonHo Rha

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Abstract

Background: The purpose of this study was to evaluate the intermediate-term oncological outcomes after (RAL-NU) for UUT-UC. Patients and Methods: Between May 2007 and December 2010, 32 patients with UUT-UC underwent RAL-NU. Data were obtained from a prospectively maintained database. Results: Median patient age was 66.5 years. Final pathological stage was pathologic stage Ta (pTa) in 12.5% (n = 4) of patients, pT1 in 28.1% (n = 9), pT2 in 18.8% (n = 6), pT3 in 40.6% (n = 13), and pT4 in 0%. High-grade lesions were present in 81.2% (n = 26) of patients and multifocal disease was present in 25.0% (n = 8). Positive surgical margins occurred in 1 patient. Median follow-up was 45.5 months (range, 24-65). At 2 and 5 years, overall survival was 81.3% and 60.9%; cancer-specific survival was 87.3% and 75.8%, and nonurothelial recurrence-free survival was 71.5% and 68.1%, respectively. On univariate analysis, female sex, positive surgical margins, and pathological tumor stage pT2 and higher are associated with reduced recurrence-free survival (P =.035 and.011, respectively). On multivariate analysis, only female sex and pathological stage pT2 or higher were significant factors (P =.020 and.049, respectively). No factors were found to affect cancer-specific survival. Conclusion: To our knowledge, this represents the largest and longest follow-up after RAL-NU to date. Intermediate-term oncological outcomes seem comparable with those of open and laparoscopic nephroureterectomy. We recommend further larger studies with longer follow-up periods to further define the role of RAL-NU in the treatment of UUT-UC.

Original languageEnglish
Pages (from-to)515-521
Number of pages7
JournalClinical Genitourinary Cancer
Volume11
Issue number4
DOIs
Publication statusPublished - 2013 Dec 1

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Urinary Tract
Carcinoma
Survival
Recurrence
Neoplasms
Multivariate Analysis
Databases

All Science Journal Classification (ASJC) codes

  • Oncology
  • Urology

Cite this

@article{a45682ac847a418e8d186e100473c43d,
title = "Intermediate-term outcomes of robot-assisted laparoscopic nephroureterectomy in upper urinary tract urothelial carcinoma",
abstract = "Background: The purpose of this study was to evaluate the intermediate-term oncological outcomes after (RAL-NU) for UUT-UC. Patients and Methods: Between May 2007 and December 2010, 32 patients with UUT-UC underwent RAL-NU. Data were obtained from a prospectively maintained database. Results: Median patient age was 66.5 years. Final pathological stage was pathologic stage Ta (pTa) in 12.5{\%} (n = 4) of patients, pT1 in 28.1{\%} (n = 9), pT2 in 18.8{\%} (n = 6), pT3 in 40.6{\%} (n = 13), and pT4 in 0{\%}. High-grade lesions were present in 81.2{\%} (n = 26) of patients and multifocal disease was present in 25.0{\%} (n = 8). Positive surgical margins occurred in 1 patient. Median follow-up was 45.5 months (range, 24-65). At 2 and 5 years, overall survival was 81.3{\%} and 60.9{\%}; cancer-specific survival was 87.3{\%} and 75.8{\%}, and nonurothelial recurrence-free survival was 71.5{\%} and 68.1{\%}, respectively. On univariate analysis, female sex, positive surgical margins, and pathological tumor stage pT2 and higher are associated with reduced recurrence-free survival (P =.035 and.011, respectively). On multivariate analysis, only female sex and pathological stage pT2 or higher were significant factors (P =.020 and.049, respectively). No factors were found to affect cancer-specific survival. Conclusion: To our knowledge, this represents the largest and longest follow-up after RAL-NU to date. Intermediate-term oncological outcomes seem comparable with those of open and laparoscopic nephroureterectomy. We recommend further larger studies with longer follow-up periods to further define the role of RAL-NU in the treatment of UUT-UC.",
author = "Lim, {Sey Kiat} and Shin, {Tae Young} and Kim, {Kwang Hyun} and Byungha Chung and Hong, {Sung Joon} and Youngdeuk Choi and KoonHo Rha",
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Intermediate-term outcomes of robot-assisted laparoscopic nephroureterectomy in upper urinary tract urothelial carcinoma. / Lim, Sey Kiat; Shin, Tae Young; Kim, Kwang Hyun; Chung, Byungha; Hong, Sung Joon; Choi, Youngdeuk; Rha, KoonHo.

In: Clinical Genitourinary Cancer, Vol. 11, No. 4, 01.12.2013, p. 515-521.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Intermediate-term outcomes of robot-assisted laparoscopic nephroureterectomy in upper urinary tract urothelial carcinoma

AU - Lim, Sey Kiat

AU - Shin, Tae Young

AU - Kim, Kwang Hyun

AU - Chung, Byungha

AU - Hong, Sung Joon

AU - Choi, Youngdeuk

AU - Rha, KoonHo

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N2 - Background: The purpose of this study was to evaluate the intermediate-term oncological outcomes after (RAL-NU) for UUT-UC. Patients and Methods: Between May 2007 and December 2010, 32 patients with UUT-UC underwent RAL-NU. Data were obtained from a prospectively maintained database. Results: Median patient age was 66.5 years. Final pathological stage was pathologic stage Ta (pTa) in 12.5% (n = 4) of patients, pT1 in 28.1% (n = 9), pT2 in 18.8% (n = 6), pT3 in 40.6% (n = 13), and pT4 in 0%. High-grade lesions were present in 81.2% (n = 26) of patients and multifocal disease was present in 25.0% (n = 8). Positive surgical margins occurred in 1 patient. Median follow-up was 45.5 months (range, 24-65). At 2 and 5 years, overall survival was 81.3% and 60.9%; cancer-specific survival was 87.3% and 75.8%, and nonurothelial recurrence-free survival was 71.5% and 68.1%, respectively. On univariate analysis, female sex, positive surgical margins, and pathological tumor stage pT2 and higher are associated with reduced recurrence-free survival (P =.035 and.011, respectively). On multivariate analysis, only female sex and pathological stage pT2 or higher were significant factors (P =.020 and.049, respectively). No factors were found to affect cancer-specific survival. Conclusion: To our knowledge, this represents the largest and longest follow-up after RAL-NU to date. Intermediate-term oncological outcomes seem comparable with those of open and laparoscopic nephroureterectomy. We recommend further larger studies with longer follow-up periods to further define the role of RAL-NU in the treatment of UUT-UC.

AB - Background: The purpose of this study was to evaluate the intermediate-term oncological outcomes after (RAL-NU) for UUT-UC. Patients and Methods: Between May 2007 and December 2010, 32 patients with UUT-UC underwent RAL-NU. Data were obtained from a prospectively maintained database. Results: Median patient age was 66.5 years. Final pathological stage was pathologic stage Ta (pTa) in 12.5% (n = 4) of patients, pT1 in 28.1% (n = 9), pT2 in 18.8% (n = 6), pT3 in 40.6% (n = 13), and pT4 in 0%. High-grade lesions were present in 81.2% (n = 26) of patients and multifocal disease was present in 25.0% (n = 8). Positive surgical margins occurred in 1 patient. Median follow-up was 45.5 months (range, 24-65). At 2 and 5 years, overall survival was 81.3% and 60.9%; cancer-specific survival was 87.3% and 75.8%, and nonurothelial recurrence-free survival was 71.5% and 68.1%, respectively. On univariate analysis, female sex, positive surgical margins, and pathological tumor stage pT2 and higher are associated with reduced recurrence-free survival (P =.035 and.011, respectively). On multivariate analysis, only female sex and pathological stage pT2 or higher were significant factors (P =.020 and.049, respectively). No factors were found to affect cancer-specific survival. Conclusion: To our knowledge, this represents the largest and longest follow-up after RAL-NU to date. Intermediate-term oncological outcomes seem comparable with those of open and laparoscopic nephroureterectomy. We recommend further larger studies with longer follow-up periods to further define the role of RAL-NU in the treatment of UUT-UC.

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