The Effect of Diagnostic Ureterorenoscopy on Intravesical Recurrence in Patients Undergoing Nephroureterectomy for Primary Upper Tract Urinary Carcinoma

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dc.authorid0000-0002-8357-5744
dc.authorwosidakgül, murat/AGE-2468-2022
dc.authorwosidEskicorapci, Saadettin/W-9548-2018
dc.authorwosidDEGER, MUTLU/U-3585-2018
dc.contributor.authorİzol, Volkan
dc.contributor.authorDeğer, Mutlu
dc.contributor.authorÖzden, Ender
dc.contributor.authorBolat, Deniz
dc.contributor.authorArgun, Burak
dc.contributor.authorBaltacı, Sümer
dc.contributor.authorBayazıt, Yıldırım
dc.contributor.authorAkgül, Hacı Murat
dc.date.accessioned2022-05-11T14:04:58Z
dc.date.available2022-05-11T14:04:58Z
dc.date.issued2021
dc.departmentFakülteler, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Üroloji Ana Bilim Dalı
dc.description.abstractObjective: The objective of this study is to evaluate the effect of diagnostic ureterorenoscopy (URS) prior to radical nephroureterectomy (RNU) on intravesical recurrence (IVR), in patients with primary upper urinary tract urothelial carcinoma (UTUC). Materials and Methods: Retrospective analysis of 354 patients, who underwent RNU for UTUC from 10 urology centers between 2005 and 2019, was performed. The primary endpoint was the occurrence of IVR after RNU. Patients were divided into URS prior to RNU (Group 1) and no URS prior to RNU (Group 2). Rates of IVR after RNU were compared, and a Cox proportional hazards model was used to evaluate potential predictors of IVR. Results: After exclusion, a total of 194 patients were analyzed: Group 1 n = 95 (49.0%) and Group 2 n = 99 (51.0%). In Group 1, a tumor biopsy and histopathological confirmation during URS were performed in 58 (61.1%). The mean follow-up was 39.17 +/- 39.3 (range 12-250) months. In 54 (27.8%) patients, IVR was recorded after RNU, and the median recurrence time within the bladder was 10.0 (3-144) months. IVR rate was 38.9% in Group 1 versus 17.2% in Group 2 (p = 0.001). In Group 1, IVR rate was 43.1% in those undergoing intraoperative biopsy versus 32.4% of patients without biopsy during diagnostic URS (p =0.29). Intravesical recurrence-free survival (IRFS) was longer in Group 2 compared to Group 1 (median IRFS was 111 vs. 60 months in Groups 2 and 1, respectively (p< 0.001)). Univariate analysis revealed that IRFS was significantly associated with URS prior to RNU (HR: 2.9, 95% CI 1.65-5.41; p < 0.001). In multivariate analysis, URS prior to RNU (HR: 3.5, 95% CI 1.74-7.16; p < 0.001) was found to be an independent prognostic factor for IRFS. Conclusion: Diagnostic URS was associated with the poor IRFS following RNU for primary UTUC. The decision for a diagnostic URS with or without tumor biopsy should be reserved for cases where this information might influence further treatment decisions.
dc.identifier.doi10.1159/000511650
dc.identifier.endpage297
dc.identifier.issn0042-1138
dc.identifier.issn1423-0399
dc.identifier.issue45385en_US
dc.identifier.pmid33264798
dc.identifier.startpage291
dc.identifier.urihttps://doi.org/10.1159/000511650
dc.identifier.urihttps://hdl.handle.net/20.500.11776/4854
dc.identifier.volume105
dc.identifier.wosWOS:000595976100001
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakPubMed
dc.institutionauthorAkgül, Hacı Murat
dc.language.isoen
dc.publisherKarger
dc.relation.ispartofUrologia Internationalis
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectUpper urinary tract
dc.subjectUrothelial carcinoma
dc.subjectDiagnostic ureterorenoscopy
dc.subjectRadical nephroureterectomy
dc.subjectIntravesical recurrence
dc.subjectTransitional-Cell-Carcinoma
dc.subjectUrothelial Carcinoma
dc.subjectRadical Nephroureterectomy
dc.subjectUreteroscopic Biopsy
dc.subjectOncological Outcomes
dc.subjectImpact
dc.subjectBladder
dc.subjectPredictors
dc.subjectManagement
dc.titleThe Effect of Diagnostic Ureterorenoscopy on Intravesical Recurrence in Patients Undergoing Nephroureterectomy for Primary Upper Tract Urinary Carcinoma
dc.typeArticle

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