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- Title
84: Is Ipsilateral Adrenalectomy Necessary for Nephroureterectomy in Treating Localized Upper Urinary Tract Urothelial Carcinoma?
- Authors
Shiu-Dong Chung; Ming-Kuen Lai; Kuo-How Huang; Chao-Yuan Huang; Yeong-Shiau Pu; Shih-Chieh chueh; Hong-Jeng Yu
- Abstract
Introduction: To evaluate the oncologic safety of nephroureterctomy without concomitant ipsilateral adrenalectomy in treating patients with localized upper urinary tract urothelial carcinoma. Methods: From 1996 to 2006, 154 patients (65 men and 89 women, mean age 64.5 years) with clinically localized upper urinary tract urothelial carcinoma treated by radical nephroureterectomy and bladder cuff resection were retrospectively evaluated. Among them, 104 patients underwent nephroureterectomy without concomitant ipsilateral adrenalectomy, whereas nephroureterectomy and ipsilateral adrenalectomy was performed in the other 50 patients. Cancer-specific, metastasis and local recurrence survival and local recurrence free survival during a follow-up of median 46 months were assessed to evaluate the oncologic safety of adrenal-sparing nephroureterectomy for localized upper tract urothelial carcinoma. Results: No patient had adrenal metastasis by pathological examination among the 50 adrenalectomized patients. A total of 5 patients developed local recurrences during followup; including 3 of the 104 adrenalectomysparing and 2 of the 50 adrenalectomized patients (P=0.715, Chi-square test). Five of the 50 patients with adrenalectomy and 7 of the other 104 patients without adrenalectomy had distant metastases during follow-up (P=0.479, chi-square test). The five-year local recurrence free survival (P=0.659, log-rank test), metastasis-free survival ( P=0.345, log-rank test), and cancer-specific survival ( P=0.273, logrank test) did not have significant difference between both groups. Conclusions: To our knowledge, this is the only study in recent 2 decades to evaluate the necessity of ipsilateral adrenalectomy in treating localized upper urinary tract urothelial carcinoma. Adrenalsparing nephroureterectomy seems justified for patients with clinically localized upper urinary tract urothelial carcinoma.
- Subjects
KIDNEY surgery; URETER surgery; ADRENALECTOMY; CYSTOTOMY; URINARY organ diseases; CANCER patients
- Publication
Indian Journal of Urology, 2008, Vol 24, pS80
- ISSN
0970-1591
- Publication type
Article