We have located links that may give you full text access.
Ureteroscopic treatment and surveillance of upper urinary tract transitional cell carcinoma.
Journal of Urology 1997 May
PURPOSE: We determined the efficacy of ureteroscopic treatment of upper urinary tract transitional cell carcinoma.
MATERIALS AND METHODS: Of 92 patients diagnosed with upper urinary tract transitional cell carcinoma at our institution from 1985 to 1995, 38 (41 kidneys) underwent ureteroscopic treatment and followup. Semirigid and flexible ureteroscopes were used to examine the collecting system. Tumors were biopsied, and treated with fulguration, the neodymium:YAG laser and/or the holmium:YAG laser. Patients were treated every 6 to 12 weeks until tumor-free and then followed on a strict endoscopic protocol.
RESULTS: Mean and median followup was 35.1 and 26 months, respectively (range 3 to 116). Grading of ureteroscopic biopsies was possible in 40 of 41 cases. Initial grading of tumors was low (grade 1 or 1 to 2) in 21 kidneys, grade 2 in 14 and grade 3 in 5. Of 41 kidneys 28 (68%) were documented as tumor-free ureteroscopically at some time following treatment, including 8 (29%) with subsequent recurrences that were treated endoscopically and 24 (86%) with no evidence of disease at the most recent followup. No patient to date has had progression of disease during endoscopic followup. High tumor grade, size and multifocality were significantly associated with tumor persistence and recurrence. Location in the kidney versus ureter was not a significant prognostic factor. Of the recurrent tumors 75% were not identified radiographically but were only discovered endoscopically. Two of 8 kidneys removed after endoscopic treatment had no tumor stage (pT0).
CONCLUSIONS: Endoscopic treatment of upper urinary tract transitional cell carcinoma is a reasonable method to treat carefully select patients based on strict indications. Complete endoscopic followup at regular intervals is essential to rule out recurrences.
MATERIALS AND METHODS: Of 92 patients diagnosed with upper urinary tract transitional cell carcinoma at our institution from 1985 to 1995, 38 (41 kidneys) underwent ureteroscopic treatment and followup. Semirigid and flexible ureteroscopes were used to examine the collecting system. Tumors were biopsied, and treated with fulguration, the neodymium:YAG laser and/or the holmium:YAG laser. Patients were treated every 6 to 12 weeks until tumor-free and then followed on a strict endoscopic protocol.
RESULTS: Mean and median followup was 35.1 and 26 months, respectively (range 3 to 116). Grading of ureteroscopic biopsies was possible in 40 of 41 cases. Initial grading of tumors was low (grade 1 or 1 to 2) in 21 kidneys, grade 2 in 14 and grade 3 in 5. Of 41 kidneys 28 (68%) were documented as tumor-free ureteroscopically at some time following treatment, including 8 (29%) with subsequent recurrences that were treated endoscopically and 24 (86%) with no evidence of disease at the most recent followup. No patient to date has had progression of disease during endoscopic followup. High tumor grade, size and multifocality were significantly associated with tumor persistence and recurrence. Location in the kidney versus ureter was not a significant prognostic factor. Of the recurrent tumors 75% were not identified radiographically but were only discovered endoscopically. Two of 8 kidneys removed after endoscopic treatment had no tumor stage (pT0).
CONCLUSIONS: Endoscopic treatment of upper urinary tract transitional cell carcinoma is a reasonable method to treat carefully select patients based on strict indications. Complete endoscopic followup at regular intervals is essential to rule out recurrences.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app