Differential Risk Factors for Early Intravesical Recurrence After Radical Nephroureterectomy for Upper Urinary Tract Carcinoma According to the History of Non-Muscle Invasive Bladder Cancer.

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Tác giả: Hideki Adachi, Kohei Hashimoto, Naoki Ito, Ryuichi Kato, Shuichi Kato, Genki Kobayashi, Ko Kobayashi, Yasuharu Kunishima, Yuki Kyoda, Takeshi Maehana, Naoya Masumori, Masanori Matsukawa, Shintaro Miyamoto, Ippei Muranaka, Manabu Okada, Shunsuke Sato, Tetsuya Shindo, Akio Takayanagi, Toshiaki Tanaka, Yohei Ueki, Atsushi Wanifuchi

Ngôn ngữ: eng

Ký hiệu phân loại: 954.0312 *South Asia India

Thông tin xuất bản: Australia : International journal of urology : official journal of the Japanese Urological Association , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 753288

OBJECTIVES: To evaluate the preoperative risk factors for early intravesical recurrence after radical nephroureterectomy (RNU) in patients with upper urinary tract carcinoma (UTUC) according to the history of non-muscle invasive bladder cancer (NMIBC). METHODS: We retrospectively evaluated patients who underwent RNU for UTUC between 2012 and 2022 at 14 hospitals. Early recurrence was defined as intravesical pathologically confirmed recurrence within 1 year after RNU. Patients who received single-dose immediate intravesical instillation (IVI) as prevention for intravesical recurrence were excluded. Using preoperative factors, we examined the risk factors for early intravesical recurrences in patients with and without a history of NMIBC. Death from any cause within 1 year after RNU was regarded as a competitive risk. RESULTS: We included 504 UTUC patients who were treated with RNU. Among these patients, 126 (25.0%) had a history of NMIBC, whereas 378 (75%) did not. According to multivariate analysis, the presence of macrohematuria, positive cytology in self-voided urine, and performing diagnostic ureteroscopy prior to RNU were risk factors in patients without a history of NMIBC. On the other hand, an NMIBC diagnosis within 1 year prior to RNU and an extravesical approach for bladder cuff management were risk factors in RNU-treated patients with a history of NMIBC. CONCLUSIONS: Early intravesical recurrence risk factors differ between UTUC patients with and without a history of NMIBC. Different stratification may be needed to predict intravesical recurrence risk in these two types of UTUC patients.
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