The comparison of oncologic outcomes between open and laparoscopic radical nephroureterectomy for the treatment of upper tract urothelial carcinoma: A Korean multicenter collaborative study

Urothelial Cancer-Advanced Research and Treatment (UCART) Study Group

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose :We compared oncologic outcomes of patients with upper tract urothelial carcinoma (UTUC) who underwent open nephroureterectomy (ONU) or laparoscopic nephroureterectomy (LNU). Materials and Methods: Consecutive cases of ONU and LNU between 2000 and 2012 at five participating institutions were included in this retrospective analysis. Clinical characteristics and pathologic outcomes were compared between the two surgical approaches. The influence of the type of surgical approach on intravesical recurrence-free survival (IVRFS), progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS) was analyzed using the Kaplan-Meier method and differences were assessed with the log-rank test. Predictors of IVRFS, PFS, CSS, and OS were also analyzed with a multivariable Cox regression model. Results: A total of 1,521 patients with UTUC were eligible for the present study (ONU, 906; LNU, 615). The estimated 5-year IVRFS (57.8 vs. 51.0%, p=0.010), CSS (80.4 vs. 76.4%, p=0.032), and OS (75.8 vs. 71.4%, p=0.026) rates were significantly different between the two groups in favor of LNU. Moreover, in patients with locally advanced disease (pT3/pT4), the LNU group showed better 5-year IVRFS (62.9 vs. 54.1%, p=0.038), CSS (64.3 vs. 56.9%, p=0.022), and OS (60.4 vs. 53.1%, p=0.018) rates than the ONU group. Multivariable Cox regression analyses showed that type of surgical approach was independently associated with IVRFS, but was not related to PFS, CSS, and OS. Conclusion: Our findings indicate that LNU provided better oncologic control of IVRFS, CSS, and OS compared with ONU for the management of patients with UTUC.

Original languageEnglish
Pages (from-to)240-251
Number of pages12
JournalCancer Research and Treatment
Volume51
Issue number1
DOIs
Publication statusPublished - 2019 Jan 1

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Multicenter Studies
Carcinoma
Survival
Therapeutics
Recurrence
Disease-Free Survival
Neoplasms
Proportional Hazards Models
Regression Analysis

Keywords

  • Laparoscopy
  • Malignant disease
  • Survival
  • Transitional cell cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

The comparison of oncologic outcomes between open and laparoscopic radical nephroureterectomy for the treatment of upper tract urothelial carcinoma : A Korean multicenter collaborative study. / Urothelial Cancer-Advanced Research and Treatment (UCART) Study Group.

In: Cancer Research and Treatment, Vol. 51, No. 1, 01.01.2019, p. 240-251.

Research output: Contribution to journalArticle

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title = "The comparison of oncologic outcomes between open and laparoscopic radical nephroureterectomy for the treatment of upper tract urothelial carcinoma: A Korean multicenter collaborative study",
abstract = "Purpose :We compared oncologic outcomes of patients with upper tract urothelial carcinoma (UTUC) who underwent open nephroureterectomy (ONU) or laparoscopic nephroureterectomy (LNU). Materials and Methods: Consecutive cases of ONU and LNU between 2000 and 2012 at five participating institutions were included in this retrospective analysis. Clinical characteristics and pathologic outcomes were compared between the two surgical approaches. The influence of the type of surgical approach on intravesical recurrence-free survival (IVRFS), progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS) was analyzed using the Kaplan-Meier method and differences were assessed with the log-rank test. Predictors of IVRFS, PFS, CSS, and OS were also analyzed with a multivariable Cox regression model. Results: A total of 1,521 patients with UTUC were eligible for the present study (ONU, 906; LNU, 615). The estimated 5-year IVRFS (57.8 vs. 51.0{\%}, p=0.010), CSS (80.4 vs. 76.4{\%}, p=0.032), and OS (75.8 vs. 71.4{\%}, p=0.026) rates were significantly different between the two groups in favor of LNU. Moreover, in patients with locally advanced disease (pT3/pT4), the LNU group showed better 5-year IVRFS (62.9 vs. 54.1{\%}, p=0.038), CSS (64.3 vs. 56.9{\%}, p=0.022), and OS (60.4 vs. 53.1{\%}, p=0.018) rates than the ONU group. Multivariable Cox regression analyses showed that type of surgical approach was independently associated with IVRFS, but was not related to PFS, CSS, and OS. Conclusion: Our findings indicate that LNU provided better oncologic control of IVRFS, CSS, and OS compared with ONU for the management of patients with UTUC.",
keywords = "Laparoscopy, Malignant disease, Survival, Transitional cell cancer",
author = "{Urothelial Cancer-Advanced Research and Treatment (UCART) Study Group} and Kim, {Tae Heon} and Bumsik Hong and Seo, {Ho Kyung} and Kang, {Seok Ho} and Ku, {Ja Hyeon} and Jeong, {Byong Chang}",
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T1 - The comparison of oncologic outcomes between open and laparoscopic radical nephroureterectomy for the treatment of upper tract urothelial carcinoma

T2 - A Korean multicenter collaborative study

AU - Urothelial Cancer-Advanced Research and Treatment (UCART) Study Group

AU - Kim, Tae Heon

AU - Hong, Bumsik

AU - Seo, Ho Kyung

AU - Kang, Seok Ho

AU - Ku, Ja Hyeon

AU - Jeong, Byong Chang

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Purpose :We compared oncologic outcomes of patients with upper tract urothelial carcinoma (UTUC) who underwent open nephroureterectomy (ONU) or laparoscopic nephroureterectomy (LNU). Materials and Methods: Consecutive cases of ONU and LNU between 2000 and 2012 at five participating institutions were included in this retrospective analysis. Clinical characteristics and pathologic outcomes were compared between the two surgical approaches. The influence of the type of surgical approach on intravesical recurrence-free survival (IVRFS), progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS) was analyzed using the Kaplan-Meier method and differences were assessed with the log-rank test. Predictors of IVRFS, PFS, CSS, and OS were also analyzed with a multivariable Cox regression model. Results: A total of 1,521 patients with UTUC were eligible for the present study (ONU, 906; LNU, 615). The estimated 5-year IVRFS (57.8 vs. 51.0%, p=0.010), CSS (80.4 vs. 76.4%, p=0.032), and OS (75.8 vs. 71.4%, p=0.026) rates were significantly different between the two groups in favor of LNU. Moreover, in patients with locally advanced disease (pT3/pT4), the LNU group showed better 5-year IVRFS (62.9 vs. 54.1%, p=0.038), CSS (64.3 vs. 56.9%, p=0.022), and OS (60.4 vs. 53.1%, p=0.018) rates than the ONU group. Multivariable Cox regression analyses showed that type of surgical approach was independently associated with IVRFS, but was not related to PFS, CSS, and OS. Conclusion: Our findings indicate that LNU provided better oncologic control of IVRFS, CSS, and OS compared with ONU for the management of patients with UTUC.

AB - Purpose :We compared oncologic outcomes of patients with upper tract urothelial carcinoma (UTUC) who underwent open nephroureterectomy (ONU) or laparoscopic nephroureterectomy (LNU). Materials and Methods: Consecutive cases of ONU and LNU between 2000 and 2012 at five participating institutions were included in this retrospective analysis. Clinical characteristics and pathologic outcomes were compared between the two surgical approaches. The influence of the type of surgical approach on intravesical recurrence-free survival (IVRFS), progression-free survival (PFS), cancer-specific survival (CSS), and overall survival (OS) was analyzed using the Kaplan-Meier method and differences were assessed with the log-rank test. Predictors of IVRFS, PFS, CSS, and OS were also analyzed with a multivariable Cox regression model. Results: A total of 1,521 patients with UTUC were eligible for the present study (ONU, 906; LNU, 615). The estimated 5-year IVRFS (57.8 vs. 51.0%, p=0.010), CSS (80.4 vs. 76.4%, p=0.032), and OS (75.8 vs. 71.4%, p=0.026) rates were significantly different between the two groups in favor of LNU. Moreover, in patients with locally advanced disease (pT3/pT4), the LNU group showed better 5-year IVRFS (62.9 vs. 54.1%, p=0.038), CSS (64.3 vs. 56.9%, p=0.022), and OS (60.4 vs. 53.1%, p=0.018) rates than the ONU group. Multivariable Cox regression analyses showed that type of surgical approach was independently associated with IVRFS, but was not related to PFS, CSS, and OS. Conclusion: Our findings indicate that LNU provided better oncologic control of IVRFS, CSS, and OS compared with ONU for the management of patients with UTUC.

KW - Laparoscopy

KW - Malignant disease

KW - Survival

KW - Transitional cell cancer

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