Sung Han Kim, Mi Kyung Song, Jung Kwon Kim, Bumsik Hong, Seok Ho Kang, Ja Hyeon Ku, Byong Chang Jeong, Ho Kyung Seo, On behalf of Urothelial Cancer-Advanced Research and Treatment (UCART) Study Group
Cancer Res Treat. 2019;51(3):963-972. Published online October 12, 2018
Purpose
The purpose of this study was to compare oncologic outcomes between open nephroureterectomy (ONU) and laparoscopic nephroureterectomy (LNU) in patients with upper tract urothelial carcinoma.
Materials and Methods
The medical records of consecutive ONU and LNU cases from five tertiary institutions were retrospectively analyzed between 2000 and 2012. The propensity-score matching methodology was used to compare the two surgical approaches in terms of age, body mass index, American Society of Anesthesiologists score, tumor location, grade, pathologic T and N categories, the presence of lymphovascular invasion, and follow-up duration. The Kaplan-Meier with log-rank tests and clustered Cox regression were used to compare the estimated rates of survival for each surgical approach and to investigate the effect of the surgical approach on each prognostic outcome.
Results
Six hundred thirty-eight propensity-score matching pairs (n=1,276) were compared; LNU was significantly better than ONU in all types of survival, including intravesical recurrencefree survival (IVRFS), disease-free survival, overall survival (OS), and cancer-specific survival (CSS) (p < 0.05). The 3-year OS and CSS rates were significantly higher with LNU than with ONU (p < 0.05). Compared with ONU, LNU had significantly better 3-year OS and CSS rates (82.9% and 86.2% vs. 78.3% and 81.8%); there were no differences at 5 years. In subgroup analysis of the early-staged group, advanced-stage group, lymph node–positive group, and lymph node–negative group, the two approaches did not significantly affect prognostic outcomes, except LNU improved the IVRFS in the lymph node–negative or no history of previous bladder cancer group.
Conclusion
LNU had a significantly better prognostic outcome than ONU after propensity-score matching.
Citations
Citations to this article as recorded by
Laparoscopic Versus Open Nephroureterectomy for Upper Tract Urothelial Carcinoma: A Systematic Review and Meta-Analysis of Propensity-Score Matched Studies Shidong Deng, Lingzhi Liu, Yurou Wang, Chuan Zhou, Huihui Zhang Surgical Innovation.2024; 31(5): 520. CrossRef
Differential effect of surgical technique on intravesical recurrence after radical nephroureterectomy in patients with upper tract urothelial cancer: a systematic review and Meta-analysis Ichiro Tsuboi, Akihiro Matsukawa, Mehdi Kardoust Parizi, Jakob Klemm, Robert J Schulz, Anna Cadenar, Stefano Mancon, Sever Chiujdea, Tamás Fazekas, Marcin Miszczyk, Ekaterina Laukhtina, Tatsushi Kawada, Satoshi Katayama, Takehiro Iwata, Kensuke Bekku, Koi World Journal of Urology.2024;[Epub] CrossRef
Comparing Oncological and Perioperative Outcomes of Open versus Laparoscopic versus Robotic Radical Nephroureterectomy for the Treatment of Upper Tract Urothelial Carcinoma: A Multicenter, Multinational, Propensity Score-Matched Analysis Nico C. Grossmann, Francesco Soria, Tristan Juvet, Aaron M. Potretzke, Hooman Djaladat, Alireza Ghoreifi, Eiji Kikuchi, Andrea Mari, Zine-Eddine Khene, Kazutoshi Fujita, Jay D. Raman, Alberto Breda, Matteo Fontana, John P. Sfakianos, John L. Pfail, Ekater Cancers.2023; 15(5): 1409. CrossRef
Factors Predicting Oncological Outcomes of Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma in Taiwan I-Hsuan Alan Chen, Chao-Hsiang Chang, Chi-Ping Huang, Wen-Jeng Wu, Ching-Chia Li, Chung-Hsin Chen, Chao-Yuan Huang, Chi-Wen Lo, Chih-Chin Yu, Chung-You Tsai, Wei-Che Wu, Jen-Shu Tseng, Wun-Rong Lin, Yuan-Hong Jiang, Yu-Khun Lee, Yeong-Chin Jou, Ian-Seng C Frontiers in Oncology.2022;[Epub] CrossRef
Robotic Radical Nephroureterectomy with Bladder Cuff Excision for Upper Tract Urothelial Carcinoma: A Trend Analysis of Utilization and a Comparative Study Hoyoung Bae, Jae Hoon Chung, Wan Song, Minyong Kang, Hwang Gyun Jeon, Byong Chang Jeong, Seong Il Seo, Seong Soo Jeon, Hyun Moo Lee, Hyun Hwan Sung Cancers.2022; 14(10): 2497. CrossRef
Oncological outcomes of laparoscopic versus open nephroureterectomy for the treatment of upper tract urothelial carcinoma: an updated meta-analysis Radosław Piszczek, Łukasz Nowak, Wojciech Krajewski, Joanna Chorbińska, Sławomir Poletajew, Marco Moschini, Krzysztof Kaliszewski, Romuald Zdrojowy World Journal of Surgical Oncology.2021;[Epub] CrossRef
Laparoscopic compared with open nephroureterectomy in upper urinary tract urothelial carcinoma: A systemic review and a meta‐analysis Guihong Liu, Zeqin Yao, Guoqiang Chen, Yalang Li, Bing Liang International Journal of Clinical Practice.2021;[Epub] CrossRef
RETRACTED: Open Nephroureterectomy Compared to Laparoscopic in Upper Urinary Tract Urothelial Carcinoma: A Meta-Analysis Guihong Liu, Zeqin Yao, Guoqiang Chen, Yalang Li, Bing Liang Frontiers in Surgery.2021;[Epub] CrossRef
A retrospective multicenter comparison of conditional cancer-specific survival between laparoscopic and open radical nephroureterectomy in locally advanced upper tract urothelial carcinoma Sung Han Kim, Mi Kyung Song, Ja Hyeon Ku, Seok Ho Kang, Byong Chang Jeong, Bumsik Hong, Ho Kyung Seo, Isaac Yi Kim PLOS ONE.2021; 16(10): e0255965. CrossRef
Risk factor analysis of intravesical recurrence after retroperitoneoscopic nephroureterectomy for upper tract urothelial carcinoma Masato Yanagi, Tsutomu Hamasaki, Jun Akatsuka, Yuki Endo, Hayato Takeda, Yukihiro Kondo BMC Urology.2021;[Epub] CrossRef
Diagnosis, management, and follow-up of upper tract urothelial carcinoma: an interdisciplinary collaboration between urology and radiology Jacob L. Roberts, Fady Ghali, Lejla Aganovic, Seth Bechis, Kelly Healy, Gerant Rivera-Sanfeliz, Riccardo Autorino, Ithaar Derweesh Abdominal Radiology.2019; 44(12): 3893. CrossRef
Prognostic Value of Lymphovascular Invasion in Upper Urinary Tract Urothelial Carcinoma after Radical Nephroureterectomy: A Systematic Review and Meta-Analysis Wen Liu, Lijiang Sun, Fengju Guan, Fangming Wang, Guiming Zhang Disease Markers.2019; 2019: 1. CrossRef
Jung Kwon Kim, Sung Han Kim, Mi Kyung Song, Jungnam Joo, Seong Il Seo, Cheol Kwak, Chang Wook Jeong, Cheryn Song, Eu Chang Hwang, Ill Young Seo, Hakmin Lee, Sung-Hoo Hong, Jae Young Park, Jinsoo Chung, Korean Renal Cell Carcinoma Study Group
Cancer Res Treat. 2019;51(2):758-768. Published online September 7, 2018
Purpose
The International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) and the Memorial Sloan Kettering Cancer Center (MSKCC) risk models were developed predominantly with clear cell renal cell carcinoma (RCC). Accordingly, whether these two models could be applied to metastatic non-clear cell RCC (mNCCRCC) as well has not been well-known and was investigated herein.
Materials and Methods
From the Korean metastatic RCC registry, a total of 156 patients (8.1%) with mNCCRCC among the entire cohort of 1,922 patients were analyzed. Both models were applied to predict first-line progression-free survival (PFS), total PFS, and cancer-specific survival (CSS).
Results
The median first-line PFS, total PFS, and CSS were 5, 6, and 24 months, respectively. The IMDC risk model reliably discriminated three risk groups to predict survival: the median firstline PFS, total PFS, and CSS for the favorable, intermediate, and poor risk groups were 9, 5, and, 2 months (p=0.001); 14, 7, and 2 months (p < 0.001); and 41, 21, and 8 months (p < 0.001), all respectively. The MSKCC risk model also reliably differentiated three risk groups: 9, 5, and, 2 months (p=0.005); 10, 7, and 3 months (p=0.002); and 50, 21, and 8 months (p < 0.001), also all respectively. The concordance indices were 0.632 with the IMDC model and 0.643 with the MSKCC model for first-line PFS: 0.748 and 0.655 for CSS.
Conclusion
The current IMDC and MSKCC risk models reliably predict first-line PFS, total PFS, and CSS in mNCCRCC.
Citations
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