The Characteristics of Recurrent Upper Tract XXXX after Radical Nephroureterectomy without Bladder Cuff Excision.

@entity1 @entity1494 @entity5 @entity189 @entity3
PURPOSE: To investigate oncological outcomes based on bladder cuff excision (BCE) during radical nephroureterectomy (RNU) for upper tract @entity189 (UTUC) and to provide clinical evidence of @entity5 recurrence in @entity1 without BCE. MATERIALS AND METHODS: We retrospectively collected data of 372 consecutive @entity1 who underwent RNU at our institution from May 1989 through October 2010. After excluding some data, we reviewed 336 @entity1 for the analysis. RESULTS: Of the @entity1 who underwent RNU with BCE (n=279, 83.0%) and without BCE (n=57, 17.0%), @entity1 without BCE had poorer @entity5 -specific and overall survival rates. Among 57 @entity1 without BCE, 35 (61.4%) experienced @entity5 recurrence. Recurrence at the remnant ureter resulted in poor oncological outcomes compared to those in @entity1 with @entity1494 , but better outcomes were observed compared to recurrence at other sites. No significant predictors for @entity5 recurrence at the remnant ureter were identified. In @entity1 without BCE, pathological T stage [hazard ratio (HR), 5.73] and @entity3 (HR, 3.65) were independent predictors of @entity5 -specific survival, whereas age (HR, 1.04), pathological T stage (HR, 5.11), and positive @entity5 margin (HR, 6.50) were independent predictors of overall survival. CONCLUSION: @entity1 without BCE had poorer overall and @entity5 -specific survival after RNU than those with BCE. Most of these @entity1 experienced @entity5 recurrence at the remnant ureter and other sites. @entity1 with non-organ confined UTUC after RNU without BCE may be considered for adjuvant chemotherapy with careful follow-up.
