Long-term results of retroperitoneoscopic nephroureterectomy for upper urinary tract transitional cell carcinoma in China.
OBJECTIVE
We compared long-term clinical outcomes of upper urinary tract transitional cell carcinoma (TCC) patients treated by retroperitoneoscopic nephroureterectomy (RNU) or open radical nephroureterectomy (ONU).


METHODS
Upper urinary tract TCC patients were treated with RNU (n = 86) or ONU (n = 72) and followed-up for more than three years. Demographic and clinical data, including preoperative indexes, intraoperative indexes and long-term clinical outcomes, were retrospectively compared to determine long-term efficacy of the two procedures.


RESULTS
The RNU and ONU groups were statistically similar in age, gender, previous bladder cancer history, tumour location, pathologic tumour stage, pathologic node metastasis or tumour pathologic grade. The original surgery time required for both RNU and ONU was statistically similar, but RNU was associated with a significantly smaller volume of intraoperative estimated blood loss and shorter length of postoperative hospital stay. Follow-up (average: 42.4 months, range: 3-57) revealed that the RNU 3-year recurrence-free survival rate was 62.8% and the 3-year cancer specific survival rate was 80.7%. In the ONU group, the 3-year recurrence-free survival and the three-year cancer-specific survival rates were 59.2% and 80.3%, respectively. Neither of the survival rates were statistically different between the two groups. T stage, grade, lymph node metastasis and bladder tumour history were risk factors for tumour recurrence; the operation mode and the bladder cuff incision mode had no correlation with the recurrence-free survival.


CONCLUSIONS
The open surgery strategy and the retroperitoneoscopic nephroureterectomy strategy are equally effective for treating upper urinary tract TCC. However, the RNU procedure is less invasive, and requires a shorter duration of postoperative hospitalized care; thus, RNU is recommended as the preferred strategy.
Department of Urology, First Bethune Hospital of Jilin University, Changchun Jilin, China.
Xiao-Qing
XQ
Wang
Department of Urology, First Bethune Hospital of Jilin University, Changchun Jilin, China.
Feng-Ming
FM
Jiang
Department of Urology, First Bethune Hospital of Jilin University, Changchun Jilin, China.
Qi-Hui
QH
Chen
Department of Urology, First Bethune Hospital of Jilin University, Changchun Jilin, China.
Yu-Chuan
YC
Hou
Department of Urology, First Bethune Hospital of Jilin University, Changchun Jilin, China.
Hai-Feng
HF
Zhang
Department of Urology, First Bethune Hospital of Jilin University, Changchun Jilin, China.
Yuan-Yuan
YY
Hao
Department of Urology, First Bethune Hospital of Jilin University, Changchun Jilin, China.
Long
L
Zhang
Department of Urology, First Bethune Hospital of Jilin University, Changchun Jilin, China.
Chun-Xi
CX
Wang