Long-term follow-up and outcomes of percutaneous nephron-sparing surgery for upper tract urothelial carcinoma.

Sarmah, Piyush Bhargav, Ehsanullah, Syed Ali and Sarmah, Bhupendra Dev Long-term follow-up and outcomes of percutaneous nephron-sparing surgery for upper tract urothelial carcinoma. Indian journal of urology : IJU : journal of the Urological Society of India, 36 (4). pp. 276-281. ISSN 0970-1591. Available through UHB Open Athens

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Official URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC77591...



Upper tract urothelial carcinoma (UTUC) is uncommon, accounting for 5%-10% of all urothelial carcinomas. Current standard of care for localized disease consists of radical nephroureterectomy (RNU) which leads to loss of half the patient's functioning nephrons. Percutaneous nephron-sparing surgery (PCNSS) is an alternative minimally-invasive approach in selected cases where nephron preservation is desired. The long-term outcomes of this procedure at a single center are described.


All patients undergoing PCNSS, with the operation carried out by a single surgeon, were included. Equipment used was a standard 26Ch resectoscope through a 30Ch Amplatz sheath, with all patients receiving postoperative intrapelvic Mitomycin. Data for each patient were collected on patient age; tumor size at diagnosis; grade; stage; oncological recurrence; requirement for subsequent RNU; and overall survival. Primary outcomes were disease recurrence and overall mortality, and secondary outcome was rate of subsequent RNU.


Fifteen patients in total underwent PCNSS, 14 were diagnosed with UTUC; benign leiomyoma was proven in one patient and excluded from final analysis. Overall survival at 5 and 10 years was 92.9% and 78.6%, respectively, with disease-specific mortality at 10 years of 7.1% (one patient who developed metastatic carcinoma); 21.4% of patients had recurrent ipsilateral UTUC and all required subsequent RNU for this indication. No patients had seeding of the percutaneous tract.


PCNSS for UTUC is a feasible approach to consider in carefully selected patients who agree to intensive follow-up, even for higher grade tumors. Where recurrent UTUC occurs, further management options still exist for disease treatment.

Item Type: Article
Additional Information: Available through UHB Open Athens
Subjects: WJ Urogenital system. Urology
Divisions: Planned IP Care > Urology
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Depositing User: Beth Connors
Date Deposited: 04 Jan 2021 15:50
Last Modified: 04 Jan 2021 15:50
URI: http://www.repository.uhblibrary.co.uk/id/eprint/3796

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