Segmental ureterectomy does not compromise the oncologic outcome compared with nephroureterectomy for pure ureter cancer

Int Urol Nephrol. 2014 May;46(5):921-6. doi: 10.1007/s11255-013-0514-z. Epub 2013 Nov 8.

Abstract

Purpose: Pure ureter cancers are rare and account for only 1-3 % of urothelial carcinomas with limited data. Nowadays, nephron-sparing methods are reserved mainly for imperative cases. This study intends to assess the oncologic outcome between segmental ureterectomy (SU) and radical nephroureterectomy (RNU) for pure ureteral urothelial carcinoma.

Methods: From July 2004 to August 2010, 112 patients at a single tertiary referral center were included. Perioperative data were obtained from our institutional database. Postoperative CT scan, cystoscopy, and contralateral renal echo were performed regularly for survey of disease recurrence.

Results: The mean length of follow-up was 43.8 and 48.3 months for the RNU and SU group, respectively. The bladder recurrences, local recurrences, distant metastasis, and cancer-specific survival rates showed no significant differences between RNU and SU (36.4 vs. 34.2 %, p = 0.83; 23.4 vs. 14.3 %, p = 0.27; and 16.9 vs. 8.6 %, p = 0.244, and 13.0 vs. 5.7 %, p = 0.249, respectively).

Conclusion: The study suggested that SU is not inferior to RNU for ureter cancer in oncologic outcomes and is less invasive and better nephron preservation.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Carcinoma / complications
  • Carcinoma / secondary
  • Carcinoma / surgery*
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local*
  • Neoplasm Staging
  • Nephrectomy*
  • Retrospective Studies
  • Survival Rate
  • Ureter / surgery*
  • Ureteral Neoplasms / complications
  • Ureteral Neoplasms / pathology*
  • Ureteral Neoplasms / surgery*
  • Urinary Bladder Neoplasms / complications*