title: Role of ureteroscopic biopsy in the management of upper urinary tract malignancy.
abstract: BACKGROUND
  The aim of the study presented here was to examine the accuracy of ureteroscopic biopsy in the diagnosis of upper urinary tract transitional cell carcinoma (TCC) and whether nephron-sparing management (holmium YAG laser, transurethral resection or partial ureterectomy) is possible or not based on pathological diagnosis.
  
  
  METHODS
  Forty consecutive patients underwent ureteroscopic biopsy with the use of 3-Fr cold cup forceps. Pathological diagnosis of the biopsy sample and grade or stage of surgically resected tumors were compared. In patients with grade 1 or 2 TCC diagnosed by ureteroscopic biopsy, the disease-free and survival rates determined whether nephron-sparing management was performed or not.
  
  
  RESULTS
  There were no major complications associated with ureteroscopic biopsy. The pathological grading of the biopsy specimen was almost the same as that of the surgically resected specimen. Eighty five percent of grade 2 or 3 TCC showed muscle invasive disease. There were no significant differences in the disease-free and survival rates between the nephroureterectomy and the nephron-sparing management groups, except for grade 3 or pT3 tumors.
  
  
  CONCLUSIONS
  Ureteroscopic biopsy is safe and accurate if sufficient tissue sample is obtained. Ureteroscopic biopsy should be performed in patients who require nephron-sparing management. Nephroureterectomy can be avoided if the tumor is confirmed as low-grade.
authors: Department of Urology, Saiseikai Shimonoseki General Hospital, 3-4-1 Kifune-cho, Shimonoseki, Yamaguchi, Japan. k-siraisi@simo.saiseikai.or.jp
authors: Koji
authors: K
authors: Shiraishi
authors: Satoshi
authors: S
authors: Eguchi
authors: Jun
authors: J
authors: Mohri
authors: Yoriaki
authors: Y
authors: Kamiryo
mesh_terms: D000368:Aged; D001706:Biopsy / Q000379:methods; D002295:Carcinoma, Transitional Cell / Q000473:pathology*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D015203:Reproducibility of Results; D014516:Ureteral Neoplasms / Q000473:pathology*; D018666:Ureteroscopy