title: Impact of diagnostic ureteroscopy on intravesical recurrence and survival in patients with urothelial carcinoma of the upper urinary tract.
abstract: OBJECTIVE
  We determined whether diagnostic ureteroscopy for upper urinary tract cancer affects intravesical recurrence and cancer specific mortality.
  
  
  METHODS
  In a retrospective, multi-institutional study we evaluated 208 patients undergoing nephroureterectomy for upper urinary tract cancer who had no perioperative systemic chemotherapy, history of invasive bladder cancer, distant metastasis or incomplete followup data. Of these 208 patients 55 who composed the study group underwent diagnostic ureteroscopy before nephroureterectomy while 153 serving as controls did not. We analyzed intravesical recurrence and cancer specific survival using the Kaplan-Meier method with the log rank test used to assess significance.
  
  
  RESULTS
  There was no significant difference between the 2 groups in patient characteristics or upper urinary tract cancer stage and grade while followup, and the proportion of multiple tumors and lymphovascular invasion positive tumors were significantly greater in controls. The 2-year bladder recurrence-free survival rate was 60.0% in the study group and 58.7% in controls. There was no significant difference in the intravesical recurrence rate between the 2 groups (log rank test p = 0.972). Estimated Kaplan-Meier cancer specific survival was 88.3% and 78.1% at 5 years in the study and control groups, respectively (log rank test p = 0.0687).
  
  
  CONCLUSIONS
  Diagnostic ureteroscopy did not affect intravesical recurrence or cancer specific survival in patients with upper urinary tract cancer undergoing nephroureterectomy.
authors.affiliation: Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Ishikawa
authors.forename: Takashige
authors.initials: T
authors.lastname: Abe
authors.forename: Nobuo
authors.initials: N
authors.lastname: Shinohara
authors.forename: Toru
authors.initials: T
authors.lastname: Harabayashi
authors.forename: Ataru
authors.initials: A
authors.lastname: Sazawa
authors.forename: Satoru
authors.initials: S
authors.lastname: Maruyama
authors.forename: Kanako
authors.initials: K
authors.lastname: Kubota
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Matsuno
authors.forename: Takahiro
authors.initials: T
authors.lastname: Osawa
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Shinno
authors.forename: Akira
authors.initials: A
authors.lastname: Kumagai
authors.forename: Masaki
authors.initials: M
authors.lastname: Togashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Matsuda
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Mori
authors.forename: Katsuya
authors.initials: K
authors.lastname: Nonomura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D007682:Kidney Pelvis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000401:mortality*; D009392:Nephrectomy; D012189:Retrospective Studies; D015996:Survival Rate; D014516:Ureteral Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D018666:Ureteroscopy; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology / Q000401:mortality*