title: Oncologic results of nephron sparing endoscopic approach for upper tract low grade transitional cell carcinoma in comparison to nephroureterectomy - a case control study.
abstract: BACKGROUND
  There is paucity of data as to the results of the endoscopic approach in comparison to the golden standard of nephro-ureterectomy in elective, low grade TCC, patients. Our purpose is to report our results of a nephron sparing approach compared to nephro-ureterectomy in those patients.
  
  
  METHODS
  From a retrospective data base we identified 25 patients and 23 patients who underwent a nephron sparing ureterosocpic resection and nephro-reterectomy for low grade UT-TCC, respectively. The endoscopic technique included endoscopic tumor biopsy followed by primary resection and/or fulguration. The nephron sparing group was followed by bi-annual ureteroscopy and upper tract imaging, timely cystoscopy and urine cytology collection. Data for overall and disease related mortality, bladder and ureteral TCC recurrence and renal function are reported in both groups.
  
  
  RESULTS
  Median follow - up time was 26 months. 11 (44%) patients developed bladder recurrence at a median period of 9 months after initial ureteroscopy, compared to 9 (39%) in the NUx group (P < 0.05). Recurrent ureteral low grade TCC was observed in 9 patients (median: 9 months). All were treated endoscopicaly successfully. Renal function remained stable in the nephron sparing group. No disease related mortality was recorded in the nephron-sparing group while one patient died of his disease following NUx.
  
  
  CONCLUSIONS
  Disease related mortality following a nephron sparing endoscopic approach or nephroureterectomy for low grade upper tract TCC is excellent. However, the nephron sparing approach is associated with a relatively high rate of ureteral and bladder recurrence. Therefore, a stringent follow-up protocol is required.
authors.affiliation: Institute of Urology, Rabin Medical Center - Beilinson Campus, Petah Tikva, and Sackler Faculty of Medicine, Tel Aviv University, Petah Tikva 49100 Tel Aviv, Israel. azikhof@gmail.com.
authors.forename: Azik
authors.initials: A
authors.lastname: Hoffman
authors.forename: Ofer
authors.initials: O
authors.lastname: Yossepowitch
authors.forename: Yaron
authors.initials: Y
authors.lastname: Erlich
authors.forename: Ronen
authors.initials: R
authors.lastname: Holland
authors.forename: David
authors.initials: D
authors.lastname: Lifshitz
mesh_terms: D002295:Carcinoma, Transitional Cell / Q000601:surgery*; D016022:Case-Control Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D009364:Neoplasm Recurrence, Local; D009392:Nephrectomy / Q000379:methods*; D009399:Nephrons; D012189:Retrospective Studies; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*; D014516:Ureteral Neoplasms / Q000601:surgery*; D018666:Ureteroscopy / Q000379:methods*; D001743:Urinary Bladder / Q000601:surgery