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Annals of Surgical Oncology

, Volume 26, Issue 11, pp 3774–3781 | Cite as

Long-Term Oncologic Outcomes of Laparoscopic Versus Open Radical Nephroureterectomy for Patients with T3N0M0 Upper Tract Urothelial Carcinoma: A Multicenter Cohort Study with Adjustment by Propensity Score Matching

  • Keisuke Shigeta
  • Eiji KikuchiEmail author
  • Takayuki Abe
  • Masayuki Hagiwara
  • Koichiro Ogihara
  • Tadanori Anno
  • Kota Umeda
  • Yuto Baba
  • Tansei Sanjo
  • Kazunori Shojo
  • Ryuichi Mizuno
  • Mototsugu Oya
Urologic Oncology
  • 124 Downloads

Abstract

Background

This study aimed to investigate the long-term oncologic outcomes of laparoscopic radical nephroureterectomy (LRNU) and open radical nephroureterectomy (ORNU) for patients with clinical and pathologic T3N0M0 upper tract urothelial carcinoma (UTUC).

Methods

Among 375 UTUC patients who underwent radical nephroureterectomy, this study identified 144 pT3N0M0 patients as cohort 1 after propensity score (PS) matching. Among 399 UTUC patients, the study identified 110 cT3N0M0 patients as cohort 2 after PS matching. Oncologic outcomes such as intravesical recurrence-free survival (IVRFS) and cancer-specific survival (CSS) were assessed by multivariate Cox’s regression analysis.

Results

Cohort 1 of pT3N0M0 UTUC had 3-year CSS and IVRFS rates of 67.9 and 52.7%, respectively, in the LRNU group, which were significantly lower than in the ORNU group (81.4%, p = 0.039 and 71.6%, p = 0.046). The multivariate Cox’s regression analysis identified the type of surgical approach (LRNU vs. ORNU) as one of the independent prognostic factors for CSS (hazard rate [HR], 1.88, p = 0.043) and IVRFS (HR, 1.75, p = 0.049). Cohort 2 of cT3N0M0 UTUC had 3-year CSS and IVRFS rates of 48.5 and 41.4%, respectively, in the LRNU group, which were significantly lower than in the ORNU group (65.8%, p = 0.049 and 67.2%, p = 0.047), and the type of surgical approach (LRNU vs. ORNU) remained as one of the independent prognostic factors for CSS and IVRFS.

Conclusions

Based on clinical and pathologic T3N0M0 UTUC populations after PS adjustments, LRNU resulted in poorer CSS and IVRFS than ORNU.

Notes

Acknowledgment

This work was supported in part by Grants-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technology of Japan (#10649875). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Disclosure

There are no conflicts of interest.

Supplementary material

10434_2019_7623_MOESM1_ESM.xls (37 kb)
Supplementary material 1 (XLS 37 kb)

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Copyright information

© Society of Surgical Oncology 2019

Authors and Affiliations

  • Keisuke Shigeta
    • 1
  • Eiji Kikuchi
    • 1
    Email author
  • Takayuki Abe
    • 2
  • Masayuki Hagiwara
    • 3
  • Koichiro Ogihara
    • 1
  • Tadanori Anno
    • 1
    • 4
    • 5
  • Kota Umeda
    • 6
  • Yuto Baba
    • 7
  • Tansei Sanjo
    • 8
  • Kazunori Shojo
    • 9
  • Ryuichi Mizuno
    • 1
  • Mototsugu Oya
    • 1
  1. 1.Department of UrologyKeio University School of MedicineTokyoJapan
  2. 2.Department of Preventive Medicine and Public Health, Biostatistics Unit at the Clinical Translational Research CenterKeio University School of MedicineTokyoJapan
  3. 3.Department of Urology, Tokyo Dental CollegeIchikawa General HospitalChibaJapan
  4. 4.Department of UrologySaitama City HospitalSaitamaJapan
  5. 5.Department of UrologySaitama Medical HospitalSaitamaJapan
  6. 6.Department of UrologyKawasaki Municipal HospitalKanagawaJapan
  7. 7.Department of UrologyInternational University of Health and Welfare Mita HospitalTokyoJapan
  8. 8.Department of UrologyIsehara Kyodo HospitalKanagawaJapan
  9. 9.Department of UrologyNational Hospital Organization Saitama National HospitalSaitamaJapan

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