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Volume 4, Issue 1, June 2020, Page: 6-12
Clinical Analysis of the Predictors for Intravesical Recurrence After Laparoscopic Radical Nephroureterectomy in Japanese Patients
Satoshi Fukata, Department of Urology, Kochi University School of Medicine, Nankoku, Kochi, Japan
Hideo Fukuhara, Department of Urology, Kochi University School of Medicine, Nankoku, Kochi, Japan
Shingo Ashida, Department of Urology, Kochi University School of Medicine, Nankoku, Kochi, Japan
Takashi Karashima, Department of Urology, Kochi University School of Medicine, Nankoku, Kochi, Japan
Keiji Inoue, Department of Urology, Kochi University School of Medicine, Nankoku, Kochi, Japan
Received: Dec. 5, 2019;       Accepted: Jan. 9, 2020;       Published: Jan. 21, 2020
DOI: 10.11648/j.ijcu.20200401.12      View  109      Downloads  63
Abstract
Objectives: In this study, we evaluate the clinicopathological independent prognostic factors which to predict IVR in patients who underwent Laparoscopic-assisted radical nephroureterectomy (LRNU) for upper urinary tract carcinoma (UTUC). Methods: Between April 2008 to February 2019, we analyzed 100 japanese patients who were underwent LRNU and 92 patients who were underwent open radical nephroureterectomy (ORNU) at our institutions by retrospectively. The Patients characteristics factors, the clinicopathologic factors were collected. The intravesical recurrence free survival (IVRFS) were analyzed using the Kaplan-Meier method and Univariate and multivariate method by using the Cox proportional hazards regression models were performed to identify independent risk factors for IVR after LRNU. Results: In LRNU group, IVR was observed in 39 cases (39%), and it was not significant difference compare with ORNU (P: 0.36). Tumor location (P=0.002), Tumor size (P=0.001), preoperative urine cytology (P<0.0001), the pneumoperitoneum time (P: 0.0005) and adjuvant chemotherapy (P=0.019) showed significant association with postoperative IVR. In the multivariate Cox hazard models, the tumor location (P=0.0003), positive preoperative urinary cytology (P=0.003), and absence of adjuvant chemotherapy (P=0.003) were independent risk factors for subsequent IVR. There were not associated with smoking, Brinkman index, hydronephrosis and ureterorenoscopy before RNU for IVR. Overal survival (OS) was not significant association for experience IVR (P=0.15). Conclusion: In this study, LRNU was not shown to have a significantly higher IVR compared to ORNU. Patients with ureteral cancer and positive preoperative urinary cytology had a higher risk of IVR after LRNU. The adjuvant chemotherapy was significantly decreased the risk for postoperative IVR.
Keywords
Intravesical Recurrence, Laparoscopic Nephroureterectomy, Upper tract Urothelial Carcinoma
To cite this article
Satoshi Fukata, Hideo Fukuhara, Shingo Ashida, Takashi Karashima, Keiji Inoue, Clinical Analysis of the Predictors for Intravesical Recurrence After Laparoscopic Radical Nephroureterectomy in Japanese Patients, International Journal of Clinical Urology. Vol. 4, No. 1, 2020, pp. 6-12. doi: 10.11648/j.ijcu.20200401.12
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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