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Author
Maruyama, Yuki Department of Urology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Science
Araki, Motoo Department of Urology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Science ORCID Kaken ID publons researchmap
Wada, Koichiro Department of Urology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Science ORCID researchmap
Yoshinaga, Kasumi Department of Urology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Science
Mitsui, Yosuke Department of Urology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Science
Sadahira, Takuya Department of Urology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Science
Nishimura, Shingo Department of Urology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Science
Edamura, Kohei Department of Urology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Science
Kobayashi, Yasuyuki Department of Urology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Science ORCID Kaken ID
Watanabe, Masami Department of Urology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Science Kaken ID publons researchmap
Watanabe, Toyohiko Department of Urology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Science ORCID Kaken ID publons researchmap
Monga, Manoj Department of Urology, The Cleveland Clinic
Nasu, Yasutomo Department of Urology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Science Kaken ID publons researchmap
Kumon, Hiromi Innovation Center Okayama for Nanobio-Targeted Therapy, Okayama University Kaken ID publons
Abstract
Background
Long-term survival outcomes of patients who undergo endoscopic management of non-invasive upper tract urothelial carcinoma remain uncertain. The longest mean follow-up period in previous studies was 6.1 years. This study reports the long-term outcomes of patients with upper tract urothelial carcinoma who underwent ureteroscopic ablation at a single institution over a 28-year period.
Methods
We identified all patients who underwent ureteroscopic management of upper tract urothelial carcinoma as their primary treatment at our institution between January 1991 and April 2011. Survival outcomes, including overall survival, cancer-specific survival, upper-tract recurrence-free survival and renal unit survival, were estimated using Kaplan−Meier methodology.
Results
A total of 15 patients underwent endoscopic management, with a mean age at diagnosis of 66 years. All patients underwent ureteroscopy, and biopsy-confirmed pathology was obtained. Median (range; mean) follow-up was 11.7 (2.3–20.9, 11.9) years. Upper tract recurrence occurred in 87% (n = 13) of patients. Twenty percent (n = 3) of patients proceeded to nephroureterectomy. The estimated cancer-specific survival rate was 93% at 5, 10, 15 and 20 years. Estimated overall survival rates were 86, 80, 54 and 20% at 5, 10, 15 and 20 years. Only one patient experienced cancer-specific mortality. The estimated mean and median overall survival times were 14.5 and 16.6 years, respectively. The estimated mean cancer-specific survival time was not reached.
Conclusions
Although upper tract recurrence is common, endoscopic management of non-invasive upper tract urothelial carcinoma provides a 90% cancer-specific survival rate at 20 years in selected patients.
Keywords
urothelial carcinoma
urinary tract cancer
ureteroscopy
long-term survival
renal pelvis
ureter
Note
This is a pre-copyedited, author-produced version of an article accepted for publication in Japanese Journal of Clinical Oncology following peer review. The version of record Long-term ureteroscopic management of upper tract urothelial carcinoma: 28-year single-centre experience, Japanese Journal of Clinical Oncology, Volume 51, Issue 1, January 2021, Pages 130–137 is available online at: https://doi.org/10.1093/jjco/hyaa132.
Published Date
2020-7-27
Publication Title
Japanese Journal of Clinical Oncology
Volume
volume51
Issue
issue1
Publisher
Oxford University Press
Start Page
130
End Page
137
ISSN
0368-2811
NCID
AA00690866
Content Type
Journal Article
language
英語
OAI-PMH Set
岡山大学
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DOI
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isVersionOf https://doi.org/10.1093/jjco/hyaa132