title: Oncological outcome of retroperitoneoscopic nephroureterectomy for upper urinary tract transitional cell carcinoma.
abstract: OBJECTIVE
  To report the oncological outcome of retroperitoneoscopic nephroureterectomy (RNU) with bladder cuff excision for upper urinary tract transitional cell carcinoma (TCC), and to compare the outcome with that of the traditional open nephroureterectomy (ONU).
  
  
  METHODS
  From January 2001, 48 patients with upper urinary tract TCC were enrolled in the study; 25 had RNU and 23 had ONU. Oncological parameters (disease-free survival and disease-specific survival) were calculated from the time of surgery to the date of last follow up and were analysed by the Kaplan-Meier method.
  
  
  RESULTS
  Mean follow up was 24.3 months in the RNU group, significantly shorter than in the ONU group. Bladder recurrence was identified in two patients with grade 3 pathological stage pT3, one patient with grade 3 stage pT2 disease and two patients with grade 2 stage pT2 disease. Multiple organ metastases in the lung, liver and lymph nodes were associated with bladder recurrence in two cases (grade 2 stage pT3, and grade 3 stage pT3). The recurrence rate was 20% (5 of 25 cases) and mean time to recurrence was 9.5 months. In the ONU group, bladder recurrence and metastases developed in four and three patients, respectively. The recurrence rate was 17% (4 of 23 cases) and mean time to recurrence was 23.4 months. No significant difference was detected in the disease-free survival rate and cancer-specific survival rate between the two groups (P=0.759 and P=0.866, respectively).
  
  
  CONCLUSIONS
  The oncological outcome of RNU appears to be equivalent to that of ONU. Moreover, long-term follow up is necessary to evaluate the oncological outcome in comparison to ONU.
authors.affiliation: Department of Urology, Kyorin University School of Medicine, Mitaka, Japan. toke@kyorin-u.ac.jp
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Okegawa
authors.forename: Akihiro
authors.initials: A
authors.lastname: Odagane
authors.forename: Hisamitsu
authors.initials: H
authors.lastname: Ide
authors.forename: Shigeo
authors.initials: S
authors.lastname: Horie
authors.forename: Kikuo
authors.initials: K
authors.lastname: Nutahara
authors.forename: Eiji
authors.initials: E
authors.lastname: Higashihara
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009399:Nephrons / Q000601:surgery*; D011379:Prognosis; D015996:Survival Rate; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery*