Oncologic outcomes comparison of partial ureterectomy and radical nephroureterectomy for urothelial carcinoma.

ABSTRACT

BACKGROUND: The appropriate application of various treatment for upper tract urothelial carcinomas (UTUCs) is the key to prolong the survival of UTUC patients. Herein, we used data in our database to assess the oncological outcomes between partial ureterectomy (PU) and radical nephroureterectomy (RNU). METHODS: From 2007 to 2014, 255 patients with UTUC undergoing PU or RNU in our hospital database were investigated. Perioperative, postoperative data, and pathologic outcomes were obtained from our database. Cancer-specific survival (CSS) was assessed through the Kaplan-Meier method with Cox regression models to test the effect of these two surgery types. RESULTS: The mean length of follow-up was 35.8 months (interquartile range 10-47 months). Patients with high pT stage (pT2-4) suffered shorter survival span (HR 9.370, 95% CI 2.956-29.697, P < 0.001). There were no significant differences in CSS between PU and RNU (P = 0.964). In the sub-analysis, CSS for RNU and PU showed no significant difference for pTa-1 or pT2-4 tumor patients (P = 0.516, P = 0.475, respectively). CONCLUSIONS: PU is not inferior to RNU in oncologic outcomes. Furthermore, PU is generally recognized with less invasive and better renal function preservation compared with RNU. Thus, PU would be rational for specific patients with UTUCs.