Cancer Research and Treatment

Original Articles

Genitourinary cancer

Single Early Intravesical Instillation of Epirubicin for Preventing Bladder Recurrence after Nephroureterectomy in Upper Urinary Tract Urothelial Carcinoma: Jong Hoon Lee, Chung Un Lee, Jae Hoon Chung, Wan Song, Minyong Kang, Hwang Gyun Jeon, Byong Chang Jeong, Seong Il Seo, Seong Soo Jeon, Hyun Hwan Sung; Cancer Res Treat. 2024;56(3):877-884. Published online January 17, 2024; DOI: https://doi.org/10.4143/crt.2023.1219

Purpose
We aimed to assess the effectiveness of early single intravesical administration of epirubicin in preventing intravesical recurrence after radical nephroureterectomy for upper tract urothelial carcinoma.
Materials and Methods
Patients with upper tract urothelial carcinoma who underwent radical nephroureterectomy between November 2018 and May 2022 were retrospectively reviewed. Intravesical epirubicin was administered within 48 hours if no evidence of leakage was observed. Epirubicin (50 mg) in 50 mL normal saline solution was introduced into the bladder via a catheter and maintained for 60 minutes. The severity of adverse events was graded using the Clavien-Dindo classification. We compared intravesical recurrence rate between the two groups. Multivariate analyses were performed to identify the independent predictors of bladder recurrence following radical nephroureterectomy.
Results
Epirubicin (n=55) and control (n=116) groups were included in the analysis. No grade 1 or higher bladder symptoms have been reported. A statistically significant difference in the intravesical recurrence rate was observed between the two groups (11.8% at 1 year in the epirubicin group vs. 28.4% at 1 year in the control group; log-rank p=0.039). In multivariate analysis, epirubicin instillation (hazard ratio [HR], 0.43; 95% confidence interval [CI], 0.20 to 0.93; p=0.033) and adjuvant chemotherapy (HR, 0.29; 95% CI, 0.13 to 0.65; p=0.003) were independently predictive of a reduced incidence of bladder recurrence.
Conclusion
This retrospective review revealed that a single immediate intravesical instillation of epirubicin is safe and can reduce the incidence of intravesical recurrence after radical nephroureterectomy. However, further prospective trials are required to confirm these findings.

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The role of intravesical chemotherapy following nephroureterectomy in upper tract urothelial carcinoma: A systematic review and meta-analysis
Stefano Moretto, Andrea Piccolini, Andrea Gallioli, Roberto Contieri, Nicolomaria Buffi, Giovanni Lughezzani, Alberto Breda, Michael Baboudjian, Bas WG van Rhijn, Morgan Roupret, Alessandro Uleri, Benjamin Pradere
Urologic Oncology: Seminars and Original Investigations.2025; 43(3): 191.e1. CrossRef

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Identification of Significant Prognostic Tissue Markers Associated with Survival in Upper Urinary Tract Urothelial Carcinoma Patients Treated with Radical Nephroureterectomy: A Retrospective Immunohistochemical Analysis Using Tissue Microarray: Sung Han Kim, Weon Seo Park, Boram Park, Jinsoo Chung, Jae Young Joung, Kang Hyun Lee, Ho Kyung Seo; Cancer Res Treat. 2020;52(1):128-138. Published online June 19, 2019; DOI: https://doi.org/10.4143/crt.2019.119

Abstract PDF Supplementary Material PubReader ePub

Purpose
The purpose of this study was to identify prognostic tissue markers for several survival outcomes after radical nephroureterectomy among patients with upper urinary tract urothelial carcinoma using tissue microarray and immunohistochemistry.
Materials and Methods
Retrospectively, data of 162 non-metastatic patients with upper urinary tract urothelial carcinoma after radical nephroureterectomy between 2004 and 2016 were reviewed to determine intravesical recurrence-free survival (IVRFS), disease-free survival (DFS), and overall survival (OS). The expression of 27 tissue markers on a tissue microarray of radical nephroureterectomy samples and prognostic values of clinicopathological parameters were evaluated using immunohistochemistry and Cox proportional hazard models after adjusting for significant prognostic clinicopathological variables. The expression of all tissue markers was categorized into a binary group with continuous H-scores (0-300).
Results
Median follow-up was 53.4 months (range, 3.6 to 176.5 months); and, 58 (35.8%), 48 (29.6%), and 19 (11.7%) bladder recurrence, disease progression, and all cause death, respectively, were identified. After adjusting for significant clinicopathological factors including intravesical instillation for bladder recurrence-free survival, pathologic T category and intravesical instillation for disease progression-free survival , and pathologic T category for OS (p < 0.05), IVRFS was associated with epithelial cadherin (hazard ratio [HR], 0.49), epidermal growth factor receptor/erythroblastosis oncogene B (c-erb) (HR, 2.59), and retinoblastoma protein loss (HR, 1.85); DFS was associated with cyclin D1 (HR, 2.16) and high-molecular-weight cytokeratin (HR, 0.42); OS was associated with E-cadherin (HR, 0.34) and programmed cell death 1 ligand (HR, 13.42) (p < 0.05).
Conclusion
Several significant tissue markers were associated with survival outcomes in upper urinary tract urothelial carcinoma patients treated with radical nephroureterectomy.

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A multi‐institutional retrospective study of open versus laparoscopic nephroureterectomy focused on the intravesical recurrence
Soichiro Shimura, Kazumasa Matsumoto, Masaomi Ikeda, Shigenori Moroo, Dai Koguchi, Yoshinori Taoka, Takahiro Hirayama, Yasukiyo Murakami, Takuji Utsunomiya, Daisuke Matsuda, Norihiko Okuno, Akira Irie, Masatsugu Iwamura
Asia-Pacific Journal of Clinical Oncology.2023; 19(1): 71. CrossRef
Upper Tract Urinary Carcinoma: A Unique Immuno-Molecular Entity and a Clinical Challenge in the Current Therapeutic Scenario
Giulia Mazzaschi, Giulia Claire Giudice, Matilde Corianò, Davide Campobasso, Fabiana Perrone, Michele Maffezzoli, Irene Testi, Luca Isella, Umberto Maestroni, Sebastiano Buti
Technology in Cancer Research & Treatment.2023;[Epub] CrossRef
Prognostic value of programmed death ligand‐1 and programmed death‐1 expression in patients with upper tract urothelial carcinoma
Luca Campedel, Eva Compérat, Géraldine Cancel‐Tassin, Justine Varinot, Christian Pfister, Clara Delcourt, Françoise Gobet, Mathieu Roumiguié, Pierre‐Marie Patard, Gwendoline Daniel, Pierre Bigot, Julie Carrouget, Caroline Eymerit, Stéphane Larré, Priscill
BJU International.2023; 132(5): 581. CrossRef
The Prevalence and Prognostic Role of PD-L1 in Upper Tract Urothelial Carcinoma Patients Underwent Radical Nephroureterectomy: A Systematic Review and Meta-Analysis
Yi Lu, Jiaqi Kang, Zhiwen Luo, Yuxuan Song, Jia Tian, Zhongjia Li, Xiao Wang, Li Liu, Yongjiao Yang, Xiaoqiang Liu
Frontiers in Oncology.2020;[Epub] CrossRef

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Laparoscopy versus Open Nephroureterectomy in Prognostic Outcome of Patients with Advanced Upper Tract Urothelial Cancer: A Retrospective, Multicenter, Propensity-Score Matching Analysis: 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; DOI: https://doi.org/10.4143/crt.2018.465

Abstract PDF Supplementary Material PubReader ePub

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

Prognostic effects of different nephroureterectomy techniques for upper urinary tract urothelial carcinoma: a network meta-analysis
Huan Wen, Yu Zhou, Lin Yang
BMC Cancer.2025;[Epub] CrossRef
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

7,777 View
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