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Is nephroureterectomy necessary in all cases of upper tract transitional cell carcinoma? Long-term results of conservative endourologic management of upper tract transitional cell carcinoma in individuals with a normal contralateral kidney

Objectives. To evaluate the endoscopic management of upper urinary tract transitional cell carcinoma (TCC) as a first-line treatment in patients with a normal contralateral kidney. Methods. During an 11-year period, 21 patients diagnosed with upper tract TCC were treated with conservative endourolog...

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Published in:Urology (Ridgewood, N.J.) N.J.), 2001-08, Vol.58 (2), p.174-178
Main Authors: Elliott, Daniel S, Segura, Joseph W, Lightner, Deborah, Patterson, David E, Blute, Michael L
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description Objectives. To evaluate the endoscopic management of upper urinary tract transitional cell carcinoma (TCC) as a first-line treatment in patients with a normal contralateral kidney. Methods. During an 11-year period, 21 patients diagnosed with upper tract TCC were treated with conservative endourologic techniques using either neodymium:yttrium-aluminum-garnet laser or electrocautery at our institution. The 21 patients were followed up for a mean of 6.1 years (range 1 to 11.6). Results. A total of 8 renal pelvic tumors and 13 ureteral tumors were found. All tumors were Stage T1 or less and grade 3 or less. All tumors were less than 2 cm in the greatest dimension (range 0.4 to 2). Of the 21 patients, 7 (33%) had one local recurrence and 1 (4.7%) developed two local recurrences. Of the 13 ureteral tumors, 6 (46%) recurred; 1 (12%) of the 8 renal pelvic tumors recurred. No recurrent tumor was shown to have an increase in grade. Of the 21 target renal units, 17 (81%) were preserved; 4 (19%) of 21 patients required nephroureterectomy because of tumor recurrence. Overall, 11 patients in the series died, 10 of non-TCC etiology and 1 secondary to invasive bladder TCC that developed after treatment for upper tract TCC. No patients died as a result of conservative management of their upper tract TCC. Conclusions. Endourologic techniques and conservative treatment of upper tract TCC is an evolving field; however, in properly selected patients, endoscopic treatment can be safely and effectively used as a first-line treatment for upper tract TCC.
doi_str_mv 10.1016/S0090-4295(01)01109-8
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Long-term results of conservative endourologic management of upper tract transitional cell carcinoma in individuals with a normal contralateral kidney</title><source>ScienceDirect Freedom Collection 2022-2024</source><creator>Elliott, Daniel S ; Segura, Joseph W ; Lightner, Deborah ; Patterson, David E ; Blute, Michael L</creator><creatorcontrib>Elliott, Daniel S ; Segura, Joseph W ; Lightner, Deborah ; Patterson, David E ; Blute, Michael L</creatorcontrib><description>Objectives. To evaluate the endoscopic management of upper urinary tract transitional cell carcinoma (TCC) as a first-line treatment in patients with a normal contralateral kidney. Methods. During an 11-year period, 21 patients diagnosed with upper tract TCC were treated with conservative endourologic techniques using either neodymium:yttrium-aluminum-garnet laser or electrocautery at our institution. The 21 patients were followed up for a mean of 6.1 years (range 1 to 11.6). Results. A total of 8 renal pelvic tumors and 13 ureteral tumors were found. All tumors were Stage T1 or less and grade 3 or less. All tumors were less than 2 cm in the greatest dimension (range 0.4 to 2). Of the 21 patients, 7 (33%) had one local recurrence and 1 (4.7%) developed two local recurrences. Of the 13 ureteral tumors, 6 (46%) recurred; 1 (12%) of the 8 renal pelvic tumors recurred. No recurrent tumor was shown to have an increase in grade. Of the 21 target renal units, 17 (81%) were preserved; 4 (19%) of 21 patients required nephroureterectomy because of tumor recurrence. Overall, 11 patients in the series died, 10 of non-TCC etiology and 1 secondary to invasive bladder TCC that developed after treatment for upper tract TCC. No patients died as a result of conservative management of their upper tract TCC. Conclusions. Endourologic techniques and conservative treatment of upper tract TCC is an evolving field; however, in properly selected patients, endoscopic treatment can be safely and effectively used as a first-line treatment for upper tract TCC.</description><identifier>ISSN: 0090-4295</identifier><identifier>EISSN: 1527-9995</identifier><identifier>DOI: 10.1016/S0090-4295(01)01109-8</identifier><identifier>PMID: 11489692</identifier><identifier>CODEN: URGYAZ</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Carcinoma, Transitional Cell - diagnosis ; Carcinoma, Transitional Cell - mortality ; Carcinoma, Transitional Cell - surgery ; Disease Progression ; Electrocoagulation ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms - diagnosis ; Kidney Neoplasms - mortality ; Kidney Neoplasms - surgery ; Laser Therapy ; Length of Stay ; Male ; Medical sciences ; Middle Aged ; Neoplasm Recurrence, Local - epidemiology ; Neoplasm Recurrence, Local - pathology ; Neoplasm Staging ; Nephrectomy ; Surgery (general aspects). 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Long-term results of conservative endourologic management of upper tract transitional cell carcinoma in individuals with a normal contralateral kidney</title><title>Urology (Ridgewood, N.J.)</title><addtitle>Urology</addtitle><description>Objectives. To evaluate the endoscopic management of upper urinary tract transitional cell carcinoma (TCC) as a first-line treatment in patients with a normal contralateral kidney. Methods. During an 11-year period, 21 patients diagnosed with upper tract TCC were treated with conservative endourologic techniques using either neodymium:yttrium-aluminum-garnet laser or electrocautery at our institution. The 21 patients were followed up for a mean of 6.1 years (range 1 to 11.6). Results. A total of 8 renal pelvic tumors and 13 ureteral tumors were found. All tumors were Stage T1 or less and grade 3 or less. All tumors were less than 2 cm in the greatest dimension (range 0.4 to 2). Of the 21 patients, 7 (33%) had one local recurrence and 1 (4.7%) developed two local recurrences. Of the 13 ureteral tumors, 6 (46%) recurred; 1 (12%) of the 8 renal pelvic tumors recurred. No recurrent tumor was shown to have an increase in grade. Of the 21 target renal units, 17 (81%) were preserved; 4 (19%) of 21 patients required nephroureterectomy because of tumor recurrence. Overall, 11 patients in the series died, 10 of non-TCC etiology and 1 secondary to invasive bladder TCC that developed after treatment for upper tract TCC. No patients died as a result of conservative management of their upper tract TCC. Conclusions. Endourologic techniques and conservative treatment of upper tract TCC is an evolving field; however, in properly selected patients, endoscopic treatment can be safely and effectively used as a first-line treatment for upper tract TCC.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Carcinoma, Transitional Cell - diagnosis</subject><subject>Carcinoma, Transitional Cell - mortality</subject><subject>Carcinoma, Transitional Cell - surgery</subject><subject>Disease Progression</subject><subject>Electrocoagulation</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Kidney Neoplasms - diagnosis</subject><subject>Kidney Neoplasms - mortality</subject><subject>Kidney Neoplasms - surgery</subject><subject>Laser Therapy</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - epidemiology</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Staging</subject><subject>Nephrectomy</subject><subject>Surgery (general aspects). 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Long-term results of conservative endourologic management of upper tract transitional cell carcinoma in individuals with a normal contralateral kidney</atitle><jtitle>Urology (Ridgewood, N.J.)</jtitle><addtitle>Urology</addtitle><date>2001-08-01</date><risdate>2001</risdate><volume>58</volume><issue>2</issue><spage>174</spage><epage>178</epage><pages>174-178</pages><issn>0090-4295</issn><eissn>1527-9995</eissn><coden>URGYAZ</coden><abstract>Objectives. To evaluate the endoscopic management of upper urinary tract transitional cell carcinoma (TCC) as a first-line treatment in patients with a normal contralateral kidney. Methods. During an 11-year period, 21 patients diagnosed with upper tract TCC were treated with conservative endourologic techniques using either neodymium:yttrium-aluminum-garnet laser or electrocautery at our institution. The 21 patients were followed up for a mean of 6.1 years (range 1 to 11.6). Results. A total of 8 renal pelvic tumors and 13 ureteral tumors were found. All tumors were Stage T1 or less and grade 3 or less. All tumors were less than 2 cm in the greatest dimension (range 0.4 to 2). Of the 21 patients, 7 (33%) had one local recurrence and 1 (4.7%) developed two local recurrences. Of the 13 ureteral tumors, 6 (46%) recurred; 1 (12%) of the 8 renal pelvic tumors recurred. No recurrent tumor was shown to have an increase in grade. Of the 21 target renal units, 17 (81%) were preserved; 4 (19%) of 21 patients required nephroureterectomy because of tumor recurrence. Overall, 11 patients in the series died, 10 of non-TCC etiology and 1 secondary to invasive bladder TCC that developed after treatment for upper tract TCC. No patients died as a result of conservative management of their upper tract TCC. Conclusions. Endourologic techniques and conservative treatment of upper tract TCC is an evolving field; however, in properly selected patients, endoscopic treatment can be safely and effectively used as a first-line treatment for upper tract TCC.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>11489692</pmid><doi>10.1016/S0090-4295(01)01109-8</doi><tpages>5</tpages></addata></record>
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ispartof Urology (Ridgewood, N.J.), 2001-08, Vol.58 (2), p.174-178
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source ScienceDirect Freedom Collection 2022-2024
subjects Adult
Aged
Aged, 80 and over
Biological and medical sciences
Carcinoma, Transitional Cell - diagnosis
Carcinoma, Transitional Cell - mortality
Carcinoma, Transitional Cell - surgery
Disease Progression
Electrocoagulation
Female
Follow-Up Studies
Humans
Kidney Neoplasms - diagnosis
Kidney Neoplasms - mortality
Kidney Neoplasms - surgery
Laser Therapy
Length of Stay
Male
Medical sciences
Middle Aged
Neoplasm Recurrence, Local - epidemiology
Neoplasm Recurrence, Local - pathology
Neoplasm Staging
Nephrectomy
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the urinary system
Survival Rate
Ureteral Neoplasms - diagnosis
Ureteral Neoplasms - mortality
Ureteral Neoplasms - surgery
Ureteroscopy - methods
title Is nephroureterectomy necessary in all cases of upper tract transitional cell carcinoma? Long-term results of conservative endourologic management of upper tract transitional cell carcinoma in individuals with a normal contralateral kidney
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