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Intermediate-term outcomes of robot-assisted laparoscopic nephroureterectomy in upper urinary tract urothelial carcinoma

 Sey Kiat Lim  ;  Tae-Young Shin  ;  Kwang Hyun Kim  ;  Byung Ha Chung  ;  Sung Joon Hong  ;  Young Deuk Choi  ;  Koon Ho Rha 
 CLINICAL GENITOURINARY CANCER, Vol.11(4) : 515-521, 2013 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Disease-Free Survival ; Female ; Humans ; Kidney/surgery ; Kidney Neoplasms/mortality ; Kidney Neoplasms/pathology ; Kidney Neoplasms/surgery ; Laparoscopy ; Male ; Middle Aged ; Nephrectomy/methods* ; Robotics/methods* ; Sex Factors ; Survival ; Survival Rate ; Treatment Outcome ; Urinary Tract/pathology ; Urinary Tract/surgery* ; Urologic Neoplasms/pathology ; Urologic Neoplasms/surgery* ; Urothelium/pathology ; Urothelium/surgery*
Oncological outcomes ; Overall survival ; Recurrence ; TCC ureter ; Transitional cell
BACKGROUND: The purpose of this study was to evaluate the intermediate-term oncological outcomes after (RAL-NU) for UUT-UC. PATIENTS AND METHODS: Between May 2007 and December 2010, 32 patients with UUT-UC underwent RAL-NU. Data were obtained from a prospectively maintained database. RESULTS: Median patient age was 66.5 years. Final pathological stage was pathologic stage Ta (pTa) in 12.5% (n = 4) of patients, pT1 in 28.1% (n = 9), pT2 in 18.8% (n = 6), pT3 in 40.6% (n = 13), and pT4 in 0%. High-grade lesions were present in 81.2% (n = 26) of patients and multifocal disease was present in 25.0% (n = 8). Positive surgical margins occurred in 1 patient. Median follow-up was 45.5 months (range, 24-65). At 2 and 5 years, overall survival was 81.3% and 60.9%; cancer-specific survival was 87.3% and 75.8%, and nonurothelial recurrence-free survival was 71.5% and 68.1%, respectively. On univariate analysis, female sex, positive surgical margins, and pathological tumor stage pT2 and higher are associated with reduced recurrence-free survival (P = .035 and .011, respectively). On multivariate analysis, only female sex and pathological stage pT2 or higher were significant factors (P = .020 and .049, respectively). No factors were found to affect cancer-specific survival. CONCLUSION: To our knowledge, this represents the largest and longest follow-up after RAL-NU to date. Intermediate-term oncological outcomes seem comparable with those of open and laparoscopic nephroureterectomy. We recommend further larger studies with longer follow-up periods to further define the role of RAL-NU in the treatment of UUT-UC.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kwang Hyun(김광현)
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Shin, Tae Young(신태영)
Lim, Sey Kiat(임세이캣)
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Hong, Sung Joon(홍성준) ORCID logo https://orcid.org/0000-0001-9869-065X
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