Outcomes of laparoscopic, robotic and open nephroureterectomy with bladder cuff excision in patients with T3T4 upper urinary tract urothelial carcinoma: a multi-center retrospective study.
Journal
BMC urology
Journal Volume
24
Journal Issue
1
ISSN
1471-2490
Date Issued
2024-12
Author(s)
Fang, Jen-Kai
Yeh, Hsin-Chih
Lee, Hsiang-Ying
Weng, Han-Yu
Tai, Ta-Yao
Yu, Chih-Chin
Wu, Shu-Yu
Chung, Shiu-Dong
Tsai, Chung-You
Hsueh, Thomas Y.
Chiu, Allen W.
Jiang, Yuan-Hong
Khun, Yu
Lee
Chen, I-Hsuan Alan
Lin, Jen-Tai
Chen, Yung-Tai
Lin, Chang-Min
Cheong, Ian-Seng
Huang, Hsu-Che
Lo, Shih-Hsiu
Lin, Wei-Yu
Tseng, Jen-Shu
Wu, Chia-Chang
Wang, Shian-Shiang
Chang, Yi-Huei
Chang, Chao-Hsiang
Abstract
Nephroureterectomy with bladder cuff excision is the standard treatment for high-risk upper urinary tract urothelial carcinoma (UTUC). The role of minimally invasive surgery in treating locally advanced UTUC remains controversial. This study aimed to compare the outcomes of open, laparoscopic, and robotic surgeries for managing locally advanced UTUC. We retrospectively reviewed 705 patients with locally advanced UTUC from multiple institutions throughout Taiwan. Perioperative outcomes and oncological outcomes, such as cancer-specific survival, overall survival, disease-free survival and bladder-free survival, were compared between the open, laparoscopic and robotic groups. The minimally invasive group had better overall and cancer-specific survival (CSS) rates. The 2-year CSS rates of the open, laparoscopic and robotic groups were 71%, 83%, and 77% respectively (p < 0.001). The robotic group had similar outcomes to the laparoscopic group. (p = 0.061, 0.825, 0.341 for OS, CSS, DFS respectively.) More lymph node dissections were performed and more lymph nodes were harvested in the robotic group (p = 0.009). Our results demonstrated that minimally invasive surgery, including laparoscopic and robotic surgery, for locally advanced UTUC resulted in oncological outcomes that are non-inferior to those of open surgery.
Subjects
Minimally invasive surgery
Robotic surgery
Upper tract urothelial carcinoma
SDGs
Type
journal article