Do transperitoneal and retroperitoneal hand-assisted laparoscopic nephroureterectomy have different effects on intravesical recurrence?

Ta Yao Tai, Che Yuan Hu, Chao Yuan Huang, Kuo How Huang, Huai Ching Tai, Yung Ming Lin

Research output: Contribution to journalArticle

Abstract

Objectives: Some studies have shown that in patients with upper tract urothelial carcinoma (UTUC) who have undergone hand-assisted laparoscopic nephroureterectomy (HALNU), the narrow working space and inevitable manipulation that occurs during the retroperitoneal approach (RP-HALNU) enhances tumor cell seeding in the bladder mucosa. This study was an attempt to investigate the differences in intravesical recurrence between transperitoneal HALNU (TP-HALNU) and RP-HALNU. Methods: From 1999 to 2011, a total of 197 patients with UTUC were enrolled. After excluding those with a previous history of bladder cancer, 170 patients were analyzed. 65 of these underwent RP-HALNU, and 105 of these underwent TP-HALNU. The median follow-up periods were 39.2 and 46.2 months. Tumor location was divided into three groups: in the renal pelvis, in the ureter, and in both the renal pelvis and ureter. Results: There was no significant difference in the intravesical recurrence rate in relation to the different surgical approaches (p = 0.10), but tumor location in both the renal pelvis and ureter significantly increased the risk (Hazard ratio [HR] = 3.11, p = 0.01). In addition, advanced T stage (HR = 9.63, p < 0.01) was the only significant risk factor related to death. Conclusions: In patients with UTUC, tumor location in both the renal pelvis and ureter determined higher susceptibility to intravesical recurrence. However, different surgical approaches to HALNU were not a significant risk factor for intravesical recurrence.

Original languageEnglish
JournalUrological Science
DOIs
Publication statusAccepted/In press - 2017 Jan 1

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Kidney Pelvis
Hand
Ureter
Recurrence
Carcinoma
Neoplasms
Urinary Bladder Neoplasms
Mucous Membrane
Urinary Bladder
Odds Ratio

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

@article{5af0e87767d549b68fcc2cbb33d4cfe2,
title = "Do transperitoneal and retroperitoneal hand-assisted laparoscopic nephroureterectomy have different effects on intravesical recurrence?",
abstract = "Objectives: Some studies have shown that in patients with upper tract urothelial carcinoma (UTUC) who have undergone hand-assisted laparoscopic nephroureterectomy (HALNU), the narrow working space and inevitable manipulation that occurs during the retroperitoneal approach (RP-HALNU) enhances tumor cell seeding in the bladder mucosa. This study was an attempt to investigate the differences in intravesical recurrence between transperitoneal HALNU (TP-HALNU) and RP-HALNU. Methods: From 1999 to 2011, a total of 197 patients with UTUC were enrolled. After excluding those with a previous history of bladder cancer, 170 patients were analyzed. 65 of these underwent RP-HALNU, and 105 of these underwent TP-HALNU. The median follow-up periods were 39.2 and 46.2 months. Tumor location was divided into three groups: in the renal pelvis, in the ureter, and in both the renal pelvis and ureter. Results: There was no significant difference in the intravesical recurrence rate in relation to the different surgical approaches (p = 0.10), but tumor location in both the renal pelvis and ureter significantly increased the risk (Hazard ratio [HR] = 3.11, p = 0.01). In addition, advanced T stage (HR = 9.63, p < 0.01) was the only significant risk factor related to death. Conclusions: In patients with UTUC, tumor location in both the renal pelvis and ureter determined higher susceptibility to intravesical recurrence. However, different surgical approaches to HALNU were not a significant risk factor for intravesical recurrence.",
author = "Tai, {Ta Yao} and Hu, {Che Yuan} and Huang, {Chao Yuan} and Huang, {Kuo How} and Tai, {Huai Ching} and Lin, {Yung Ming}",
year = "2017",
month = "1",
day = "1",
doi = "10.1016/j.urols.2017.07.006",
language = "English",
journal = "Urological Science",
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Do transperitoneal and retroperitoneal hand-assisted laparoscopic nephroureterectomy have different effects on intravesical recurrence? / Tai, Ta Yao; Hu, Che Yuan; Huang, Chao Yuan; Huang, Kuo How; Tai, Huai Ching; Lin, Yung Ming.

In: Urological Science, 01.01.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Do transperitoneal and retroperitoneal hand-assisted laparoscopic nephroureterectomy have different effects on intravesical recurrence?

AU - Tai, Ta Yao

AU - Hu, Che Yuan

AU - Huang, Chao Yuan

AU - Huang, Kuo How

AU - Tai, Huai Ching

AU - Lin, Yung Ming

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Objectives: Some studies have shown that in patients with upper tract urothelial carcinoma (UTUC) who have undergone hand-assisted laparoscopic nephroureterectomy (HALNU), the narrow working space and inevitable manipulation that occurs during the retroperitoneal approach (RP-HALNU) enhances tumor cell seeding in the bladder mucosa. This study was an attempt to investigate the differences in intravesical recurrence between transperitoneal HALNU (TP-HALNU) and RP-HALNU. Methods: From 1999 to 2011, a total of 197 patients with UTUC were enrolled. After excluding those with a previous history of bladder cancer, 170 patients were analyzed. 65 of these underwent RP-HALNU, and 105 of these underwent TP-HALNU. The median follow-up periods were 39.2 and 46.2 months. Tumor location was divided into three groups: in the renal pelvis, in the ureter, and in both the renal pelvis and ureter. Results: There was no significant difference in the intravesical recurrence rate in relation to the different surgical approaches (p = 0.10), but tumor location in both the renal pelvis and ureter significantly increased the risk (Hazard ratio [HR] = 3.11, p = 0.01). In addition, advanced T stage (HR = 9.63, p < 0.01) was the only significant risk factor related to death. Conclusions: In patients with UTUC, tumor location in both the renal pelvis and ureter determined higher susceptibility to intravesical recurrence. However, different surgical approaches to HALNU were not a significant risk factor for intravesical recurrence.

AB - Objectives: Some studies have shown that in patients with upper tract urothelial carcinoma (UTUC) who have undergone hand-assisted laparoscopic nephroureterectomy (HALNU), the narrow working space and inevitable manipulation that occurs during the retroperitoneal approach (RP-HALNU) enhances tumor cell seeding in the bladder mucosa. This study was an attempt to investigate the differences in intravesical recurrence between transperitoneal HALNU (TP-HALNU) and RP-HALNU. Methods: From 1999 to 2011, a total of 197 patients with UTUC were enrolled. After excluding those with a previous history of bladder cancer, 170 patients were analyzed. 65 of these underwent RP-HALNU, and 105 of these underwent TP-HALNU. The median follow-up periods were 39.2 and 46.2 months. Tumor location was divided into three groups: in the renal pelvis, in the ureter, and in both the renal pelvis and ureter. Results: There was no significant difference in the intravesical recurrence rate in relation to the different surgical approaches (p = 0.10), but tumor location in both the renal pelvis and ureter significantly increased the risk (Hazard ratio [HR] = 3.11, p = 0.01). In addition, advanced T stage (HR = 9.63, p < 0.01) was the only significant risk factor related to death. Conclusions: In patients with UTUC, tumor location in both the renal pelvis and ureter determined higher susceptibility to intravesical recurrence. However, different surgical approaches to HALNU were not a significant risk factor for intravesical recurrence.

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