Outcomes of laparoscopic, robotic and open nephroureterectomy with bladder cuff excision in patients with T3T4 upper urinary tract urothelial carcinoma: a multi-center retrospective study

被引：1

作者：

Fang, Jen-Kai ^{[1
]}

Yeh, Hsin-Chih ^{[2
,3
,4
,5
]}

Lee, Hsiang-Ying ^{[3
,4
,6
]}

Weng, Han-Yu ^{[7
]}

Tai, Ta-Yao ^{[7
]}

Huang, Chao-Yuan ^{[8
]}

Hong, Jian-Hua ^{[8
,9
]}

Yu, Chih-Chin ^{[10
,11
]}

Wu, Shu-Yu ^{[10
,11
]}

Chung, Shiu-Dong ^{[12
,13
]}

Tsai, Chung-You ^{[13
,14
]}

Hsueh, Thomas Y. ^{[15
,16
]}

Chiu, Allen W. ^{[16
]}

Jiang, Yuan-Hong ^{[11
]}

Khun, Yu ^{[1
]}

Chen, I-Hsuan Alan ^{[17
]}

Lin, Jen-Tai ^{[17
]}

Chen, Yung-Tai ^{[8
,18
,19
]}

Lin, Chang-Min ^{[19
]}

Cheong, Ian-Seng ^{[20
]}

Huang, Hsu-Che ^{[21
,22
]}

Lo, Shih-Hsiu ^{[23
]}

Lin, Wei-Yu ^{[24
,25
,26
]}

Tseng, Jen-Shu ^{[27
,28
,29
]}

Wu, Chia-Chang ^{[30
,31
,32
]}

Wang, Shian-Shiang ^{[33
,34
,35
]}

Chang, Yi-Huei ^{[1
]}

Chang, Chao-Hsiang ^{[1
]}

机构：

[1] China Med Univ, China Med Univ Hosp, Dept Urol, Taichung, Taiwan

[2] Kaohsiung Municipal Tatung Hosp, Dept Urol, Kaohsiung, Taiwan

[3] Kaohsiung Med Univ Hosp, Dept Urol, Kaohsiung, Taiwan

[4] Kaohsiung Med Univ, Coll Med, Sch Med, Dept Urol, Kaohsiung, Taiwan

[5] Kaohsiung Med Univ, Grad Inst Med, Coll Med, Kaohsiung, Taiwan

[6] Kaohsiung Med Univ, Grad Inst Clin Med, Coll Med, Kaohsiung, Taiwan

[7] Natl Cheng Kung Univ, Natl Cheng Kung Univ Hosp, Coll Med, Dept Urol, Tainan, Taiwan

[8] Natl Taiwan Univ, Natl Taiwan Univ Hosp, Coll Med, Dept Urol, Taipei, Taiwan

[9] Natl Taiwan Univ, Inst Biomed Engn, Taipei, Taiwan

[10] Taipei Tzuchi Hosp, Buddhist Tzu Chi Med Fdn, Dept Surg, Div Urol, New Taipei City, Taiwan

[11] Buddhist Tzu Chi Univ, Sch Med, Dept Urol, Hualien, Taiwan

[12] Taipei Med Univ Hosp, Sleep Res Ctr, Taipei, Taiwan

[13] Far Eastern Mem Hosp, Dept Surg, Div Urol, New Taipei City, Taiwan

[14] Yuan Ze Univ, Dept Elect Engn, Taoyuan, Taiwan

[15] Taipei City Hosp, Renai Branch, Dept Surg, Div Urol, Taipei, Taiwan

[16] Natl Yang Ming Chiao Tung Univ, Sch Med, Dept Urol, Taipei 11221, Taiwan

[17] Kaohsiung Vet Gen Hosp, Dept Surg, Div Urol, Kaohsiung, Taiwan

[18] Postal Hosp, Dept Urol, Taipei, Taiwan

[19] Taiwan Adventist Hosp, Dept Urol, Taipei, Taiwan

[20] Chiayi Christian Hosp, Ditmanson Med Fdn, Dept Urol, Chiayi 600, Taiwan

[21] Cardinal Tien Hosp, Dept Surg, Div Urol, New Taipei City 23148, Taiwan

[22] Natl Taiwan Normal Univ, Coll Sci, Dept Life Sci, Taipei 11677, Taiwan

[23] Taipei Med Univ, Taipei Med Univ Hosp, Dept Urol, Taipei City, Taiwan

[24] Chang Gung Mem Hosp, Dept Surg, Div Urol, Chiayi, Taiwan

[25] Chang Gung Univ Sci & Technol, Chia Yi Campus, Chiayi, Taiwan

[26] Chang Gung Univ, Coll Med, Dept Med, Taoyuan, Taiwan

[27] Mackay Mem Hosp, Dept Urol, Taipei, Taiwan

[28] MacKay Med Coll, Taipei, Taiwan

[29] Natl Yang Ming Chiao Tung Univ, Inst Biomed Informat, Taipei, Taiwan

[30] Taipei Med Univ, Shuang Ho Hosp, Dept Urol, New Taipei City, Taiwan

[31] Taipei Med Univ, Coll Med, Sch Med, Dept Urol, Taipei, Taiwan

[32] Taipei Med Univ, TMU Res Ctr Urol & Kidney TMU RCUK, Taipei, Taiwan

[33] Taichung Vet Gen Hosp, Dept Surg, Div Urol, Taichung, Taiwan

[34] Chung Shan Med Univ, Inst Med, Taichung, Taiwan

[35] Natl Chi Nan Univ, Dept Appl Chem, Nantou, Taiwan

来源：

BMC UROLOGY | 2024年 / 24卷 / 01期

关键词：

Upper tract urothelial carcinoma; Minimally invasive surgery; Robotic surgery; DIABETES-MELLITUS; CANCER;

D O I：

10.1186/s12894-024-01622-5

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Background Nephroureterectomy with bladder cuff excision is the standard treatment for high-risk upper urinary tract urothelial carcinoma (UTUC). The role of minimally invasive surgery in treating locally advanced UTUC remains controversial. This study aimed to compare the outcomes of open, laparoscopic, and robotic surgeries for managing locally advanced UTUC. Methods We retrospectively reviewed 705 patients with locally advanced UTUC from multiple institutions throughout Taiwan. Perioperative outcomes and oncological outcomes, such as cancer-specific survival, overall survival, disease-free survival and bladder-free survival, were compared between the open, laparoscopic and robotic groups. Results The minimally invasive group had better overall and cancer-specific survival (CSS) rates. The 2-year CSS rates of the open, laparoscopic and robotic groups were 71%, 83%, and 77% respectively (p < 0.001). The robotic group had similar outcomes to the laparoscopic group. (p = 0.061, 0.825, 0.341 for OS, CSS, DFS respectively.) More lymph node dissections were performed and more lymph nodes were harvested in the robotic group (p = 0.009). Conclusions Our results demonstrated that minimally invasive surgery, including laparoscopic and robotic surgery, for locally advanced UTUC resulted in oncological outcomes that are non-inferior to those of open surgery.

引用

页数：13

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