Endourologic Management of Patients with Upper-Tract Transitional-Cell Carcinoma Long-Term Follow-up in a Single Center.

Autor: Steven J. Sowter, Cristian P. Ilie, Ioannis Efthimiou, David A. Tolley
Předmět:
Zdroj: Journal of Endourology; Sep2007, Vol. 21 Issue 9, p1005-1010, 6p
Abstrakt: Purpose To evaluate the outcome of endoscopic management of upper-tract transitional-cell carcinoma (TCC).Patients and Methods From March 1991 to March 2006, 40 patients with upper-tract TCC were treated by an endoscopic approach as the primary management 37 (90.2) by ureteroscopy and by percutaneous techniques or both approaches in 2 cases each (5). Follow-up was between 5 and 115 months (mean 41.6 months). Most of the patients, 26 (65), had a normal contralateral kidney, and the indication for conservative management was low tumor grade or tumor size (<2 cm) and patient commitment to a rigorous follow-up protocol. Absolute and relative indications for conservative management such as solitary kidney were met in 14 patients (35).Results Treatment consisted of electrocautery only in 15 cases (36.6), neodymiumYAG or holmiumYAG laser only in 11 (26.8), and combinations in 15 (36.6). Most of the patients (74.3) had an upper-tract recurrence. The renal-preservation rate was 70.7, and the survival rate was 80.Conclusions Conservative treatment is preferred in patients with bilateral disease, a solitary kidney, or co-morbidities that contraindicate major surgery. Patients with low-grade, low-stage disease and normal contralateral kidneys also benefit from this approach provided adequate endoscopic follow-up can be achieved and the surgeon has a low threshold for carrying out ablative surgery. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index