Immediate Nephroureterectomy or After Attempting Conservative Treatment, on Elective Indications, for Upper Urinary Tract XXXX : Comparison of the Pathology Reports on a Retrospective Monocentric Study.

@entity1 @entity5 @entity189 @entity454
OBJECTIVE: Conservative treatment (CT) with flexible ureteroscopy and laser ablation is an alternative to radical nephroureterectomy (RNU) for the treatment of the upper urinary tract @entity189 (UTUC). The purpose of this study was to compare the pathology results obtained after immediate RNU or after attempt of CT for elective indication. @entity1 AND METHODS: A retrospective study was conducted in a single tertiary center. All @entity1 who had an RNU for @entity189 between 2007 and 2012 have been included. The @entity1 were classified into two groups: group 1 is immediate RNU, and group 2 is RNU after CT (only elective indications). Preoperative data collected were as follows: age, sex, @entity454 , radiological classification for @entity5 staging (TNM), @entity5 size, localization, and multifocal indication of CT. The pathological RNU data collected were @entity5 stage and grade. The T stage was divided into two groups (primary endpoint): pTa-T1-T2 and pT3-T4. The   (2) test and Mann-Whitney was performed to compare the independent qualitative and quantitative variables, respectively. RESULTS: A total of 51 @entity1 were included (40 @entity1 in the immediate RNU group and 11 @entity1 in the delayed RNU group after CT). @entity1 in both groups had comparable characteristics regarding age, sex, location, T stage, and preoperative @entity5 grade. On final pathology, 23 @entity5 were classified as pTa-T1-T2 in the immediate RNU group compared with 6 in the delayed RNU group. Seventeen and five @entity5 were classified as T3 in group 1 and group 2, respectively. These results were not significantly different between both groups (p=0.866). The pathological RNU grade was not significantly different between the groups. CONCLUSION: Within the limits of this retrospective study, the pathological RNU data showed no significant difference when RNU was done immediately or after CT for UTUC.
