Predictive Factors for Impaired Renal Function following Nephroureterectomy in Upper Urinary Tract Urothelial Cell Carcinoma

2014 ◽  
Vol 92 (2) ◽  
pp. 169-173 ◽  
Author(s):  
O. Rodríguez Faba ◽  
J. Palou ◽  
A. Breda ◽  
P. Maroto ◽  
J.M. Fernández Gómez ◽  
...  
2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 312-312
Author(s):  
Anna Maria Leliveld ◽  
Benjamin HJ Doornweerd ◽  
Igle De Jong

312 Background: Upper urinary tract tumors (UUTT) can occur synchronous or metachronous (0.7 – 6%) with bladder tumors. The optimal imaging technique of the upper urinary tract is unclear. Studies on the accuracy of retrograde pyelography (RUP) and comparative studies on detection level are sparse. In this study we evaluated the effectiveness of a first RUP in patients with a first manifestation of urothelial cell carcinoma (UCC) in the urinary tract. Methods: In this retrospective study we evaluated all consecutive patients with pathologic proven UCC who underwent their first RUP between March 1998 and April 2008 in the University Medical Center Groningen, Netherlands. Data regarding patient and tumor characteristics, results from RUPs, use of alternative imaging techniques, treatment and outcome were collected from the electronically patient’s records. Follow up was calculated from the first RUP to the last registrated visit. Descriptive statistics have been used to evaluate the performance of the RUP. Results: A total of 156 patients underwent a first RUP because of a first manifestation of UCC of the bladder or upper urinary tract. A mean follow up of 5.09 years was achieved (range 0-13 years). On 17 RUPs (11%) abnormalities were detected. In 16 patients a malignancy was diagnosed. Except one renal cell carcinoma all tumors were UCC of the renal pelvis, ureters or both. Muscle invasive tumors were diagnosed in 7 of these 17 patients. In 30 patients (19%) no conclusive results were obtained because of failure of the RUP due to technical difficulties. In 19 of 30 patients alternative imaging was performed, with intravenous pyelography in 11 patients, computer tomography urography in 7 patients and with both in 1 patient. No UUTTs were diagnosed in this group. In 109 (70%) patients whit a negative RUP three patients developed a tumor after 8, 52, and 65 months. The latter two we consider as newly developed lesions. Conclusions: RUP in patients with a first manifestation of UCC is a very sensitive and accurate diagnostic tool in detecting UUTT.


2021 ◽  
Vol 10 (24) ◽  
pp. 5964
Author(s):  
Gaetano Ciancio ◽  
Marina M. Tabbara ◽  
Melanie Martucci ◽  
Jeffrey J. Gaynor ◽  
Mahmoud Morsi ◽  
...  

Upper urinary tract urothelial cell carcinoma (UTUC) with venous tumor thrombus (TT) that extends into the renal vein (RV) and inferior vena cava (IVC) is a rare entity and its management is a surgical challenge. We report the largest single experience of surgical management of UTUC and accompanying venous TT with radical nephroureterectomy and tumor thrombectomy (RNATT) using transplant-based (TB) surgical techniques. From September 2003 to June 2021, nine patients with UTUC and venous TT underwent RNATT. Demographics, disease characteristics, surgical details, 30-day postoperative complications, and overall survival (OS) were analyzed. All nine patients had extension of the TT into the RV. Of those, seven had additional extension of the TT into the IVC. Venous TT level was categorized as 0 (n = 2), I (n = 2), II (n = 4), and IIIa (n = 1). Median tumor size was 12 cm (range 3–20 cm). Median estimated blood loss was 300 (range 150–1000) cc. One patient was still alive at last follow-up (4 months), and in total, eight patients have died with a median time-to-death of 12 months (range 10 days–24 months). RNATT using TB maneuvers like liver mobilization and pancreas-spleen en bloc mobilization provide excellent exposure to the retroperitoneal space and enable the safe removal of UTUC with venous TT.


2016 ◽  
pp. 602-627
Author(s):  
John Fitzpatrick ◽  
Asif Muneer ◽  
Jean de la Rosette ◽  
Thomas Powles

Genitourinary cancers include tumors of the penis, bladder, prostate, testes, kidneys and ureters. Penile cancer is a rare malignancy and the diagnosis is often delayed due to patient embarrassment. Penile-preserving surgical techniques have been developed to preserve penile length. Urothelial cell carcinoma is more often encountered in bladder (95%) than in the upper urinary tract (5%). This chapter will be divided according to the two main urothelial cell carcinoma topographies: bladder and upper urinary tract. Prostate cancer is second as far as cause of cancer death is concerned, and surgical, radiotherapeutic and hormonal treatments are discussed. Most testicular cancers that arise are germ cell tumours. Renal cell carcinoma has a number of distinct pathological types. The commonest is clear cell histology which is intrinsically linked to Von Hippel-Lindau (VHL) mutations. New targeted therapies for renal carcinomas will be described in detail.


2010 ◽  
Vol 9 (2) ◽  
pp. 260
Author(s):  
M. Rouprêt ◽  
E. Comperat ◽  
S.J. Drouin ◽  
G. Cancel-Tassin ◽  
C. Gaffory ◽  
...  

2015 ◽  
Vol 68 (5) ◽  
pp. 868-879 ◽  
Author(s):  
Morgan Rouprêt ◽  
Marko Babjuk ◽  
Eva Compérat ◽  
Richard Zigeuner ◽  
Richard J. Sylvester ◽  
...  

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