Segmental ureterectomy is not inferior to radical nephroureterectomy for either middle or distal ureter urothelial cell carcinomas within 3.5 cm.
OBJECTIVE
To evaluate oncologic outcomes of segmental ureterectomy (SU) compared with radical nephroureterectomy (RNU) for urothelial carcinoma of ureter. To evaluate whether tumor position is a factor to influence outcomes of different surgical procedures.


METHODS
From November 2003 to June 2016, 131 patients with urothelial carcinoma of ureter underwent SU or RNU at our department. We used survival analysis and Cox regression models to compare oncologic outcomes after SU and RNU. Covariates included surgical type, tumor stage, cancer grade, lesion position, presence of preoperative hydronephrosis and histories of bladder cancer. Patients were divided according to lesion sites for further comparison.


RESULTS
The mean length of follow-up was 55.3 and 50.9 months for the RNU and SU group, respectively. The bladder recurrences, local recurrences, distant metastasis, cancer-specific survival and overall survival rates showed no significant differences between RNU and SU (p = 0.596, p = 0.636, p = 0.740, p = 0.809, p = 0.553, respectively). For mid-ureter or distal ureter lesions, no significant difference of oncologic outcomes between SU and RUN was observed.


CONCLUSIONS
Our study suggested SU is not inferior to RNU for either middle or distal ureter urothelial cell carcinomas.
Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No. 197, 2nd Ruijin Road, Shanghai, 200025, China.
Chen
C
Fang
Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No. 197, 2nd Ruijin Road, Shanghai, 200025, China.
Xin
X
Xie
Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No. 197, 2nd Ruijin Road, Shanghai, 200025, China.
Tianyuan
T
Xu
Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No. 197, 2nd Ruijin Road, Shanghai, 200025, China.
Wei
W
He
Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No. 197, 2nd Ruijin Road, Shanghai, 200025, China.
Hongchao
H
He
Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No. 197, 2nd Ruijin Road, Shanghai, 200025, China.
Xiaojing
X
Wang
Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No. 197, 2nd Ruijin Road, Shanghai, 200025, China.
Yu
Y
Zhu
Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No. 197, 2nd Ruijin Road, Shanghai, 200025, China.
Zhoujun
Z
Shen
Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No. 197, 2nd Ruijin Road, Shanghai, 200025, China. shaoyuanrj@126.com.|Department of Urology, Ruijin Hospital North, Shanghai Jiaotong University School of Medicine, Shanghai, China. shaoyuanrj@126.com.
Yuan
Y
Shao
D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000150:complications / Q000556:secondary / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging; D009392:Nephrectomy; D012189:Retrospective Studies; D015996:Survival Rate; D014513:Ureter / Q000473:pathology / Q000601:surgery*; D014516:Ureteral Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000556:secondary*
Nephroureterectomy; Recurrence; Segmental ureterectomy; Survival; Ureter; Urothelial carcinoma