title: Upper urinary tract transitional cell carcinoma: recurrence rate after percutaneous endoscopic resection.
abstract: OBJECTIVE
  To assess oncologic outcomes in patients undergoing percutaneous management for upper urinary tract transitional cell carcinoma (UUT-TCC) of the renal cavities.
  
  
  METHODS
  We performed a retrospective review of data for patients who underwent percutaneous conservative surgery for a UUT-TCC between 1989 and 2005: sex; age at diagnosis; mode of diagnosis; smoking; history of bladder cancer; type of surgery; complications; tumour site, size, stage and grade, and recurrence and progression. We evaluated recurrence and survival rates.
  
  
  RESULTS
  Data were analyzed for 24 patients. Median age was 70 yr. The tumour was located in the renal pelvis in 11 patients and in the caliceal system in 13 patients. Mean tumour size was 1.8 cm (range: 0.8-2.9). Four patients had a history of bladder carcinoma. Three patients experienced perioperative blood loss requiring transfusion, and one experienced colon wound. Median follow-up was 62 mo. Eight (33.3%) patients experienced local recurrence (three in the treated urinary tract, one in the contralateral tract, four in the bladder). Five patients underwent nephroureterectomy (NUT) during follow-up. Five (20.8%) patients have died, four from disease progression and one from cardiovascular causes. The 5-year disease-specific and tumour-free survival rates were 79.5% and 68%, respectively.
  
  
  CONCLUSIONS
  Percutaneous management can be recommended as an alternative to NUT or ureteroscopy for low-grade or superficial UUT-TCCs localised in the renal cavities. These patients require long-term postsurgical surveillance. For patients with high-grade or invasive tumours, open NUT remains the gold standard.
authors.affiliation: Department of Urology, Groupe Hospitalo-Universitaire EST, Pitié-Tenon, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris VI, Paris, France. mroupret@club-internet.fr
authors.forename: Morgan
authors.initials: M
authors.lastname: Rouprêt
authors.forename: Olivier
authors.initials: O
authors.lastname: Traxer
authors.forename: Mohamed
authors.initials: M
authors.lastname: Tligui
authors.forename: Pierre
authors.initials: P
authors.lastname: Conort
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Chartier-Kastler
authors.forename: François
authors.initials: F
authors.lastname: Richard
authors.forename: Olivier
authors.initials: O
authors.lastname: Cussenot
mesh_terms: D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000453:epidemiology* / Q000601:surgery*; D003558:Cystoscopy; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D012189:Retrospective Studies