What are the oncological risks of minimal access surgery for the treatment of urinary tract cancer?
OBJECTIVE
A review of the oncological safety of minimal access surgery for the treatment of urinary tract cancers. The particular areas reviewed were port-site metastases, local tumour recurrence and long-term survival.


METHODS
Review of the literature using Medline.


RESULTS
There is a low rate of port-site metastases following laparoscopic surgery for urological malignancies, these are usually related to the stage and grade of the tumour. So far follow-up data shows that laparoscopic surgery for urological malignancy does not result in higher levels of local recurrence or shorter survival than open surgery. Percutaneous (PCN) and ureteroscopic (URS) resection of TCC of the upper urinary tract are acceptable forms of treatment for grade 1 and 2 TCCs even in patients with normal contralateral kidneys. However, for grade 3 TCC nephroureterectomy should be utilised because of increased risk of local recurrence (URS) and track seeding (PCN).


CONCLUSIONS
Provided the principles of cancer surgery, combined with proper case selection are followed, minimal access surgery for urological cancer is safe and is rapidly emerging as the standard of care for many upper tract tumours.
Stewart
Grant D
GD
Scottish Lithotriptor Centre, Western General Hospital, Edinburgh EH4 2XU, UK.
Tolley
David A
DA
D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D016896:Treatment Outcome; D018666:Ureteroscopy; D014571:Urologic Neoplasms / Q000473:pathology / Q000601:surgery*