Oncological Outcomes of Distal Ureterectomy for High-Risk Urothelial Carcinoma: A Multicenter Study by The French Bladder Cancer Committee
Upper urinary tract urothelial carcinoma (UTUC) is an uncommon disease and its gold-standard treatment is radical nephroureterectomy (RNU). Distal ureterectomy (DU) might be an alternative for tumors of the distal ureter but its indications remain unclear. Here, we aimed to evaluate the oncological...
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MDPI AG
2022-11-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/21/5452 |
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| author | Alexandra Masson-Lecomte Victoire Vaillant Mathieu Roumiguié Stéphan Lévy Benjamin Pradère Michaël Peyromaure Igor Duquesne Alexandre De La Taille Cédric Lebâcle Adrien Panis Olivier Traxer Priscilla Leon Maud Hulin Evanguelos Xylinas François Audenet Thomas Seisen Yohann Loriot Yves Allory Morgan Rouprêt Yann Neuzillet |
| author_facet | Alexandra Masson-Lecomte Victoire Vaillant Mathieu Roumiguié Stéphan Lévy Benjamin Pradère Michaël Peyromaure Igor Duquesne Alexandre De La Taille Cédric Lebâcle Adrien Panis Olivier Traxer Priscilla Leon Maud Hulin Evanguelos Xylinas François Audenet Thomas Seisen Yohann Loriot Yves Allory Morgan Rouprêt Yann Neuzillet |
| author_sort | Alexandra Masson-Lecomte |
| collection | DOAJ |
| description | Upper urinary tract urothelial carcinoma (UTUC) is an uncommon disease and its gold-standard treatment is radical nephroureterectomy (RNU). Distal ureterectomy (DU) might be an alternative for tumors of the distal ureter but its indications remain unclear. Here, we aimed to evaluate the oncological outcomes of DU for UTUC of the pelvic ureter. We performed a multicenter retrospective analysis of patients with UTUC who underwent DU. The primary endpoint was 5-year cancer-specific survival (CSS), followed by overall survival (OS), intravesical recurrence-free (IVR) and homolateral urinary tract recurrence-free (HUR) survivals as secondary endpoints. Univariate and multivariate Cox regressions were performed to assess factors associated with outcomes. 155 patients were included, 91% of which were high-risk. 5-year CSS was 84.4%, OS was 71.9%, IVR-free survival was 43.6% and HUR-free survival was 74.4%. Multifocality, high grade and tumor size were the most significant predictors of survival endpoints. Of note, neither hydronephrosis nor pre-operative diagnostic ureteroscopy/JJ stent were associated with any of the endpoints. Perioperative morbidity was minimal. In conclusion, DU stands as a possible alternative to RNU for UTUC of the pelvic ureter. Close monitoring is mandatory due to the high risk of recurrence in the remaining urinary tract. |
| first_indexed | 2024-03-09T19:12:17Z |
| format | Article |
| id | doaj.art-752d10c90da74016b398e55285692ba3 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T19:12:17Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-752d10c90da74016b398e55285692ba32023-11-24T04:04:38ZengMDPI AGCancers2072-66942022-11-011421545210.3390/cancers14215452Oncological Outcomes of Distal Ureterectomy for High-Risk Urothelial Carcinoma: A Multicenter Study by The French Bladder Cancer CommitteeAlexandra Masson-Lecomte0Victoire Vaillant1Mathieu Roumiguié2Stéphan Lévy3Benjamin Pradère4Michaël Peyromaure5Igor Duquesne6Alexandre De La Taille7Cédric Lebâcle8Adrien Panis9Olivier Traxer10Priscilla Leon11Maud Hulin12Evanguelos Xylinas13François Audenet14Thomas Seisen15Yohann Loriot16Yves Allory17Morgan Rouprêt18Yann Neuzillet19Department of Urology, APHP, Hôpital Saint Louis, 75010 Paris, FranceDepartment of Urology, APHP, Hôpital Henri Mondor, Université Paris-Est Créteil, 94000 Créteil, FranceDepartment of Urology, CHU de Toulouse, UPS, Université de Toulouse, 31000 Toulouse, FranceDepartment of Urology, CHU de Toulouse, UPS, Université de Toulouse, 31000 Toulouse, FranceDepartment of Urology-UROSUD, La Croix du Sud Hospital, 31130 Quint-Fonsegrives, FranceDepartment of Urology, APHP, Hôpital Cochin, Université Paris Cité, 75014 Paris, FranceDepartment of Urology, APHP, Hôpital Cochin, Université Paris Cité, 75014 Paris, FranceDepartment of Urology, APHP, Hôpital Henri Mondor, Université Paris-Est Créteil, 94000 Créteil, FranceDepartment of Urology, APHP, Hôpital Bicêtre, Université Paris Sud-Saclay, 94270 Le Kremlin-Bicêtre, FranceDepartment of Urology, APHP, Hôpital Bicêtre, Université Paris Sud-Saclay, 94270 Le Kremlin-Bicêtre, FranceGRC 10 Lithiase Urinaire, Department of Urology, APHP, Tenon Hospital, Sorbonne University, 75020 Paris, FranceDepartment of Urology, clinique Pasteur, 17200 Royan, FranceDepartment of Urology, clinique Pasteur, 17200 Royan, FranceDepartment of Urology, APHP, Hôpital Bichat Claude-Bernard, Université Paris Cité, 75014 Paris, FranceDepartment of Urology, APHP, Hôpital Européen Georges Pompidou, Université Paris Cité, 75014 Paris, FranceGRC 5 Predictive Onco-Urology, Department of Urology, APHP, Pitié Salpêtrière Hospital, Sorbonne University, 75013 Paris, FranceDepartment of Cancer Medicine, INSERM U981, Gustave Roussy, Université Paris-Saclay, 94805 Villejuif, FranceDepartment of Pathology, Curie Institute, University of Paris-Saclay–UVSQ, 92210 Saint-Cloud, FranceGRC 5 Predictive Onco-Urology, Department of Urology, APHP, Pitié Salpêtrière Hospital, Sorbonne University, 75013 Paris, FranceDepartment of Urology, Hôpital Foch, University of Paris-Saclay–UVSQ, 92150 Suresnes, FranceUpper urinary tract urothelial carcinoma (UTUC) is an uncommon disease and its gold-standard treatment is radical nephroureterectomy (RNU). Distal ureterectomy (DU) might be an alternative for tumors of the distal ureter but its indications remain unclear. Here, we aimed to evaluate the oncological outcomes of DU for UTUC of the pelvic ureter. We performed a multicenter retrospective analysis of patients with UTUC who underwent DU. The primary endpoint was 5-year cancer-specific survival (CSS), followed by overall survival (OS), intravesical recurrence-free (IVR) and homolateral urinary tract recurrence-free (HUR) survivals as secondary endpoints. Univariate and multivariate Cox regressions were performed to assess factors associated with outcomes. 155 patients were included, 91% of which were high-risk. 5-year CSS was 84.4%, OS was 71.9%, IVR-free survival was 43.6% and HUR-free survival was 74.4%. Multifocality, high grade and tumor size were the most significant predictors of survival endpoints. Of note, neither hydronephrosis nor pre-operative diagnostic ureteroscopy/JJ stent were associated with any of the endpoints. Perioperative morbidity was minimal. In conclusion, DU stands as a possible alternative to RNU for UTUC of the pelvic ureter. Close monitoring is mandatory due to the high risk of recurrence in the remaining urinary tract.https://www.mdpi.com/2072-6694/14/21/5452distal ureterectomyurothelial carcinomacancerhigh riskcancer-specific survivalintravesical recurrence-free survival |
| spellingShingle | Alexandra Masson-Lecomte Victoire Vaillant Mathieu Roumiguié Stéphan Lévy Benjamin Pradère Michaël Peyromaure Igor Duquesne Alexandre De La Taille Cédric Lebâcle Adrien Panis Olivier Traxer Priscilla Leon Maud Hulin Evanguelos Xylinas François Audenet Thomas Seisen Yohann Loriot Yves Allory Morgan Rouprêt Yann Neuzillet Oncological Outcomes of Distal Ureterectomy for High-Risk Urothelial Carcinoma: A Multicenter Study by The French Bladder Cancer Committee Cancers distal ureterectomy urothelial carcinoma cancer high risk cancer-specific survival intravesical recurrence-free survival |
| title | Oncological Outcomes of Distal Ureterectomy for High-Risk Urothelial Carcinoma: A Multicenter Study by The French Bladder Cancer Committee |
| title_full | Oncological Outcomes of Distal Ureterectomy for High-Risk Urothelial Carcinoma: A Multicenter Study by The French Bladder Cancer Committee |
| title_fullStr | Oncological Outcomes of Distal Ureterectomy for High-Risk Urothelial Carcinoma: A Multicenter Study by The French Bladder Cancer Committee |
| title_full_unstemmed | Oncological Outcomes of Distal Ureterectomy for High-Risk Urothelial Carcinoma: A Multicenter Study by The French Bladder Cancer Committee |
| title_short | Oncological Outcomes of Distal Ureterectomy for High-Risk Urothelial Carcinoma: A Multicenter Study by The French Bladder Cancer Committee |
| title_sort | oncological outcomes of distal ureterectomy for high risk urothelial carcinoma a multicenter study by the french bladder cancer committee |
| topic | distal ureterectomy urothelial carcinoma cancer high risk cancer-specific survival intravesical recurrence-free survival |
| url | https://www.mdpi.com/2072-6694/14/21/5452 |
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