The authors from 14 French institutions analyzed patients who had undergone open (n=479) or laparoscopic (n=150) nephroureterectomy for non-metastatic upper urinary tract urothelial carcinoma between 1995 and 2009. Median age was 70 years and the male/female ratio was 2:1. Endpoints were cause-specific mortality, disease recurrence and progression to metastasis with regard to the operative approach. Recurrence-free survival was 50.7% for the open approach and 52.2% for the laparoscopic approach (p=0.07). Cause-specific survival was 78% for the open approach and 90.7% for the laparoscopic approach (p=0.06). On multivariate analysis the surgical approach was not an independent factor for outcome. The authors concluded that laparoscopic nephroureterectomy is a safe alternative approach for the treatment of non-metastatic upper urinary tract urothelial cell carcinomas.
While oncological outcome seems to be at least similar between open and laparoscopic nephroureterectomy is should be essential to duplicate all technical aspects of open nephroureterectomy including lymphadenectomy and excision of a bladder cuff.
Presented by M.M. Ariane, et al. at the 26th Annual European Association of Urology (EAU) Congress - March 18 - 21, 2011 - Austria Centre Vienna, Vienna, Austria
Reported for UroToday by Christian Doehn, MD, PhD, Department of Urology, University of Lübeck Medical School, Lübeck Germany.
View EAU 2011 Annual Meeting Coverage
