Correlation between the Timing of Diagnostic Ureteroscopy and Intravesical Recurrence in Upper Tract Urothelial Cancer

Jung Keun Lee, Ki Bom Kim, Yong Hyun Park, Jong Jin Oh, Sang Chul Lee, Chang Wook Jeong, Seong Jin Jeong, Sung Kyu Hong, Seok-Soo Byun, Sang Eun Lee

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background The purpose of this study was to evaluate the effects of the timing of diagnostic ureteroscopy (URS) relative to radical nephroureterectomy (RNU) on intravesical recurrence (IVR). Patients and Methods We retrospectively evaluated 104 patients who had undergone RNU for upper tract urothelial cancer (UTUC) at a single tertiary referral center between March 2003 and December 2012. All patients were divided depending on the timing of diagnostic URS: the no URS group (30 patients, no URS), 1-session group (33 patients, diagnostic URS immediately followed by RNU), and 2-session group (41 patients, RNU after diagnostic URS at a median time of 5 days). We analyzed for IVR-free survival using the Kaplan-Meier and Cox proportional regression methods. Results Of the 104 patients, 34 (32.6%) developed subsequent IVR at a mean interval of 7.2 months. The Kaplan-Meier curve showed that the IVR rate was significantly greater in the 2-session group than in the other groups (P =.004). Univariate analysis indicated no effect on IVR in the 1-session group compared with the no URS group (hazard ratio [HR], 95% confidence interval [CI] 1.58; 0.517-4.833). However, the 2-session group had a significantly greater number of patients with IVR than the no URS group (HR, 3.82; 95% CI 1.438-10.131). Multivariate Cox proportional analysis revealed that the 2-session group was an independent predictor of IVR in UTUC patients (HR, 3.61; 95% CI 1.039-12.557). Conclusion Delay of RNU after diagnostic URS significantly increased the risk of IVR in UTUC patients.

Original languageEnglish
Pages (from-to)e37-e41
JournalClinical Genitourinary Cancer
Volume14
Issue number1
DOIs
StatePublished - 1 Feb 2016

Fingerprint

Ureteroscopy
Recurrence
Neoplasms
Confidence Intervals
Tertiary Care Centers

Keywords

  • Diagnosis
  • Intravesical recurrence
  • Nephroureterectomy
  • Upper tract urothelial cancer
  • Ureteroscopy

Cite this

@article{54b0e3d6b33d476292b259ffd8faf1bc,
title = "Correlation between the Timing of Diagnostic Ureteroscopy and Intravesical Recurrence in Upper Tract Urothelial Cancer",
abstract = "Background The purpose of this study was to evaluate the effects of the timing of diagnostic ureteroscopy (URS) relative to radical nephroureterectomy (RNU) on intravesical recurrence (IVR). Patients and Methods We retrospectively evaluated 104 patients who had undergone RNU for upper tract urothelial cancer (UTUC) at a single tertiary referral center between March 2003 and December 2012. All patients were divided depending on the timing of diagnostic URS: the no URS group (30 patients, no URS), 1-session group (33 patients, diagnostic URS immediately followed by RNU), and 2-session group (41 patients, RNU after diagnostic URS at a median time of 5 days). We analyzed for IVR-free survival using the Kaplan-Meier and Cox proportional regression methods. Results Of the 104 patients, 34 (32.6{\%}) developed subsequent IVR at a mean interval of 7.2 months. The Kaplan-Meier curve showed that the IVR rate was significantly greater in the 2-session group than in the other groups (P =.004). Univariate analysis indicated no effect on IVR in the 1-session group compared with the no URS group (hazard ratio [HR], 95{\%} confidence interval [CI] 1.58; 0.517-4.833). However, the 2-session group had a significantly greater number of patients with IVR than the no URS group (HR, 3.82; 95{\%} CI 1.438-10.131). Multivariate Cox proportional analysis revealed that the 2-session group was an independent predictor of IVR in UTUC patients (HR, 3.61; 95{\%} CI 1.039-12.557). Conclusion Delay of RNU after diagnostic URS significantly increased the risk of IVR in UTUC patients.",
keywords = "Diagnosis, Intravesical recurrence, Nephroureterectomy, Upper tract urothelial cancer, Ureteroscopy",
author = "Lee, {Jung Keun} and Kim, {Ki Bom} and Park, {Yong Hyun} and Oh, {Jong Jin} and Lee, {Sang Chul} and Jeong, {Chang Wook} and Jeong, {Seong Jin} and Hong, {Sung Kyu} and Seok-Soo Byun and Lee, {Sang Eun}",
year = "2016",
month = "2",
day = "1",
doi = "10.1016/j.clgc.2015.07.008",
language = "English",
volume = "14",
pages = "e37--e41",
journal = "Clinical Genitourinary Cancer",
issn = "1558-7673",
publisher = "Elsevier",
number = "1",

}

TY - JOUR

T1 - Correlation between the Timing of Diagnostic Ureteroscopy and Intravesical Recurrence in Upper Tract Urothelial Cancer

AU - Lee, Jung Keun

AU - Kim, Ki Bom

AU - Park, Yong Hyun

AU - Oh, Jong Jin

AU - Lee, Sang Chul

AU - Jeong, Chang Wook

AU - Jeong, Seong Jin

AU - Hong, Sung Kyu

AU - Byun, Seok-Soo

AU - Lee, Sang Eun

PY - 2016/2/1

Y1 - 2016/2/1

N2 - Background The purpose of this study was to evaluate the effects of the timing of diagnostic ureteroscopy (URS) relative to radical nephroureterectomy (RNU) on intravesical recurrence (IVR). Patients and Methods We retrospectively evaluated 104 patients who had undergone RNU for upper tract urothelial cancer (UTUC) at a single tertiary referral center between March 2003 and December 2012. All patients were divided depending on the timing of diagnostic URS: the no URS group (30 patients, no URS), 1-session group (33 patients, diagnostic URS immediately followed by RNU), and 2-session group (41 patients, RNU after diagnostic URS at a median time of 5 days). We analyzed for IVR-free survival using the Kaplan-Meier and Cox proportional regression methods. Results Of the 104 patients, 34 (32.6%) developed subsequent IVR at a mean interval of 7.2 months. The Kaplan-Meier curve showed that the IVR rate was significantly greater in the 2-session group than in the other groups (P =.004). Univariate analysis indicated no effect on IVR in the 1-session group compared with the no URS group (hazard ratio [HR], 95% confidence interval [CI] 1.58; 0.517-4.833). However, the 2-session group had a significantly greater number of patients with IVR than the no URS group (HR, 3.82; 95% CI 1.438-10.131). Multivariate Cox proportional analysis revealed that the 2-session group was an independent predictor of IVR in UTUC patients (HR, 3.61; 95% CI 1.039-12.557). Conclusion Delay of RNU after diagnostic URS significantly increased the risk of IVR in UTUC patients.

AB - Background The purpose of this study was to evaluate the effects of the timing of diagnostic ureteroscopy (URS) relative to radical nephroureterectomy (RNU) on intravesical recurrence (IVR). Patients and Methods We retrospectively evaluated 104 patients who had undergone RNU for upper tract urothelial cancer (UTUC) at a single tertiary referral center between March 2003 and December 2012. All patients were divided depending on the timing of diagnostic URS: the no URS group (30 patients, no URS), 1-session group (33 patients, diagnostic URS immediately followed by RNU), and 2-session group (41 patients, RNU after diagnostic URS at a median time of 5 days). We analyzed for IVR-free survival using the Kaplan-Meier and Cox proportional regression methods. Results Of the 104 patients, 34 (32.6%) developed subsequent IVR at a mean interval of 7.2 months. The Kaplan-Meier curve showed that the IVR rate was significantly greater in the 2-session group than in the other groups (P =.004). Univariate analysis indicated no effect on IVR in the 1-session group compared with the no URS group (hazard ratio [HR], 95% confidence interval [CI] 1.58; 0.517-4.833). However, the 2-session group had a significantly greater number of patients with IVR than the no URS group (HR, 3.82; 95% CI 1.438-10.131). Multivariate Cox proportional analysis revealed that the 2-session group was an independent predictor of IVR in UTUC patients (HR, 3.61; 95% CI 1.039-12.557). Conclusion Delay of RNU after diagnostic URS significantly increased the risk of IVR in UTUC patients.

KW - Diagnosis

KW - Intravesical recurrence

KW - Nephroureterectomy

KW - Upper tract urothelial cancer

KW - Ureteroscopy

UR - http://www.scopus.com/inward/record.url?scp=84951827324&partnerID=8YFLogxK

U2 - 10.1016/j.clgc.2015.07.008

DO - 10.1016/j.clgc.2015.07.008

M3 - Article

C2 - 26459040

AN - SCOPUS:84951827324

VL - 14

SP - e37-e41

JO - Clinical Genitourinary Cancer

JF - Clinical Genitourinary Cancer

SN - 1558-7673

IS - 1

ER -