title: Oncologic outcomes of laparoscopic nephroureterectomy for pT3 upper urinary tract urothelial carcinoma.
abstract: OBJECTIVE
  We present the oncologic outcomes of laparoscopic nephroureterectomy management of pT3 upper urinary tract urothelial carcinoma.
  
  
  METHODS
  Between October 2003 and January 2011, 50 patients with pT3 upper urinary tract urothelial carcinoma which had pathologically confirmed underwent laparoscopic nephroureterectomy at our institution. Demographic data, perioperative results, pathological findings and oncologic outcomes were reviewed and analyzed retrospectively.
  
  
  RESULTS
  There were 36 patients (72%) of high grade lesion and 14 patients (28%) of low grade lesion. Lymphovascular invasion was observed in 16 patients (32%) and the surgical margin was positive in one patient. N stage was pN0 in 16 (32%), pN1 in 3 (6%), pN2 in 1 (2%) and pN3 in 1 (2%). The 5-year overall survival rate was 52.6% and the 5-year cancer-specific survival rate was 65.3%. Overall recurrence developed in 23 patients. There were 10 patients (20%) of urothelial recurrence which were all occurred in the bladder at the mean period of 13.6 months, and 7 patients of them were invasive bladder cancer. There were 16 patients (32%) of non-urothelial recurrence developed at the mean period of 9.69 months. On multivariate analyses lymphadenopathy and lymph node involvement of cancer (N+) were identified as independent predictive factors for the cancer-specific survival, and concomitant bladder tumor, grade and lymphovascular invasion were identified as independent predictive factors for the overall recurrence free survival.
  
  
  CONCLUSIONS
  Laparoscopic nephroureterectomy in patients with high stage upper urinary tract urothelial carcinoma appear comparable to those of open surgery in the regard of oncologic outcomes.
authors: Department of Urology School of Medicine Kyungpook National University, Daegu, Korea - tgkwon@knu.ac.kr.
authors: J N
authors: JN
authors: Lee
authors: B S
authors: BS
authors: Kim
authors: H T
authors: HT
authors: Kim
authors: T H
authors: TH
authors: Kim
authors: E S
authors: ES
authors: Yoo
authors: G S
authors: GS
authors: Choi
authors: B W
authors: BW
authors: Kim
authors: T G
authors: TG
authors: Kwon
mesh_terms: D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy / Q000706:statistics & numerical data*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000601:surgery; D009392:Nephrectomy / Q000379:methods* / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*; D014571:Urologic Neoplasms / Q000601:surgery*