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Abstract

Objectives: We determined the surgical and oncological outcomes of laparoscopic nephroureterectomy (LNU) in comparison to open nephroureterectomy (ONU) and factors predicting bladder recurrence after nephroureterectomy. Methods: We retrospectively reviewed and compared the data of patients who underwent ONU or LNU for non-metastatic, upper-tract urothelial carcinoma from 2000 to 2016. The primary endpoint was to determine bladder cancer recurrence-free survival (BCRFS), cancer-specific survival (CSS), and overall survival (OS). The data were analysed using Student’s t-test, Chi-square test, and Kaplan-Meier curve. Results: Total of 50 patients, of which 24 had LNU and 26 had ONU, met the inclusion criteria. Median durations of follow-up were 4.2 and 6.5 years ( p =0.1070) in LNU and ONU, respectively. Operative time, blood loss and hospital stay were significantly lower in the LNU group than in the ONU group ( p =0.0001, p =0.0001, p =0.0018). Cancer-specific survival rate in the LNU was 75% and ONU was 73.3% ( p =0.1902), whereas BCRFS and CSS were not significantly different in both groups (log-rank test; BCRFS: p =0.809 and CSS: p =0.802). Patients who underwent ureteroscopy with biopsy ( p =0.001), had multifocality ( p =0.001) and previous history of (H/O) bladder cancer ( p =0.020) were at significant risk for developing bladder cancer recurrence after nephroureterectomy. Conclusion: Laparoscopic nephroureterectomy can benefit patients because of its minimal invasiveness, and oncologic outcomes are comparable to ONU. Preoperative ureteroscopy with biopsy, multifocality and previous H/O bladder cancer might be risk factors for bladder cancer recurrence.

Article Type

Research Article

First Page

25

Last Page

33

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