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Guido Dalbagni - One of the best experts on this subject based on the ideXlab platform.

Tomohiko Ichikawa - One of the best experts on this subject based on the ideXlab platform.

  • intravesical irrigation to prevent early bladder recurrence in patients undergoing laparoscopic radical Nephroureterectomy for upper urinary tract cancer
    Journal of Clinical Oncology, 2020
    Co-Authors: Takaaki Tamura, Yusuke Imamura, Shinichi Sakamoto, Akira Komiya, Satoshi Yamamoto, Maihulan Maimaiti, Maki Nagata, Tomohiko Ichikawa
    Abstract:

    454Background: The bladder carcinoma recurrence rate after Nephroureterectomy is known to be high. Here we studied the clinical benefit of Intravesical irrigation during laparoscopic radical nephro...

  • impact of post void residual urine volume on intravesical recurrence after Nephroureterectomy for upper urinary tract urothelial carcinoma
    International Journal of Urology, 2019
    Co-Authors: Tomokazu Sazuka, Yusuke Imamura, Shinichi Sakamoto, Akira Komiya, Satoshi Yamamoto, Kazuyoshi Nakamura, Tomohiko Ichikawa
    Abstract:

    OBJECTIVE: To examine the impact of post-void residual urine volume on the risk of postoperative recurrence of intravesical carcinoma in patients with upper urinary tract urothelial carcinoma undergoing Nephroureterectomy. METHODS: We retrospectively reviewed the data of 81 patients who were admitted to Chiba University Graduate School of Medicine Hospital and underwent Nephroureterectomy for upper urinary tract urothelial carcinoma without bladder carcinoma. We assessed the predictive factors for intravesical recurrence after Nephroureterectomy in all patients. Next, we compared patients with and without a residual urine volume using propensity score-matching analysis. The presence of a residual urine volume was defined as ≥30 mL. RESULTS: The median follow-up period among all patients was 48 months. The presence of pyuria and a residual urine volume were associated with bladder recurrence in the multivariate analysis. A total of 19 patients each were selected after matching, and we confirmed a significant difference between the presence and absence of a residual urine volume (P = 0.0291). The 2-year postoperative recurrence-free rate of patients with and without a residual urine volume was 32% and 82%, respectively. CONCLUSIONS: This is the first study to evaluate the post-void residual urine volume and intravesical recurrence rate after Nephroureterectomy for upper urinary tract urothelial carcinoma. The presence of residual urine might be a risk factor for postoperative recurrence of intravesical carcinoma.

  • impact of post void residual urine volume on intravesical recurrence after Nephroureterectomy for upper urinary tract urothelial carcinoma
    International Journal of Urology, 2019
    Co-Authors: Tomokazu Sazuka, Yusuke Imamura, Shinichi Sakamoto, Akira Komiya, Satoshi Yamamoto, Kazuyoshi Nakamura, Tomohiko Ichikawa
    Abstract:

    OBJECTIVE: To examine the impact of post-void residual urine volume on the risk of postoperative recurrence of intravesical carcinoma in patients with upper urinary tract urothelial carcinoma undergoing Nephroureterectomy. METHODS: We retrospectively reviewed the data of 81 patients who were admitted to Chiba University Graduate School of Medicine Hospital and underwent Nephroureterectomy for upper urinary tract urothelial carcinoma without bladder carcinoma. We assessed the predictive factors for intravesical recurrence after Nephroureterectomy in all patients. Next, we compared patients with and without a residual urine volume using propensity score-matching analysis. The presence of a residual urine volume was defined as ≥30 mL. RESULTS: The median follow-up period among all patients was 48 months. The presence of pyuria and a residual urine volume were associated with bladder recurrence in the multivariate analysis. A total of 19 patients each were selected after matching, and we confirmed a significant difference between the presence and absence of a residual urine volume (P = 0.0291). The 2-year postoperative recurrence-free rate of patients with and without a residual urine volume was 32% and 82%, respectively. CONCLUSIONS: This is the first study to evaluate the post-void residual urine volume and intravesical recurrence rate after Nephroureterectomy for upper urinary tract urothelial carcinoma. The presence of residual urine might be a risk factor for postoperative recurrence of intravesical carcinoma.

Shahrokh F. Shariat - One of the best experts on this subject based on the ideXlab platform.

  • contemporary role of lymph node dissection at the time of radical Nephroureterectomy for upper tract urothelial carcinoma
    World Journal of Urology, 2017
    Co-Authors: Thomas Seisen, Benoit Peyronnet, Shahrokh F. Shariat, Pierre Colin, Olivier Cussenot, R Renardpenna, Morgan Rouprêt
    Abstract:

    Purpose To review the contemporary data on the role of lymph node dissection (LND) at the time of radical Nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC).

  • oncological outcomes after radical Nephroureterectomy for upper tract urothelial carcinoma comparison over the three decades
    International Journal of Urology, 2012
    Co-Authors: Mehrad Adibi, Ramy F Youssef, Arthur I. Sagalowsky, Shahrokh F. Shariat, Christian Bolenz, Yair Lotan, Christopher G Wood, Francesco Montorsi, Richard Zigeuner, Vitaly Margulis
    Abstract:

    Objective:  To evaluate temporal trends in clinicopathological features and oncological outcomes after radical Nephroureterectomy for upper tract urothelial carcinoma. Methods:  Utilizing a multi-institutional database of patients treated with radical Nephroureterectomy between 1983 and 2007, we compared clinicopathological features and survival outcomes over the past three decades using the following cohorts: group 1 comprised of patients treated before the 1990s (n = 106), group 2 from 1990 to1999 (n = 655), and group 3 from 2000 to 2007 (n = 701). Survival rates were compared using Kaplan−Meier survival analysis. Results:  The study included 1462 patients, 992 men and 470 women, with 36 months median follow up (range 1–250 months) after radical Nephroureterectomy. Tumors were organ confined (≤T2/N0) in 88% and high-grade in 64%. Neoadjuvant and adjuvant systemic chemotherapy was administered in 47 (3.2%) and 171 (11.7%) patients, respectively. There was a significant increase in the use of laparoscopic radical Nephroureterectomy, endoscopic management of urothelial carcinoma and utilization of perioperative chemotherapy between decades 1 to 3. There were no significant differences in pathological stage distribution. The overall 5-year disease-free survival rates were 66 ± 5%, 68.5 ± 2% and 71 ± 2%, and the 5-year cancer-specific survival rates were 75 ± 5%, 72 ± 2%, and 75 ± 2% for groups 1, 2 and 3, respectively, with no significant statistical differences between the three decades (P > 0.05). Conclusion:  Outcomes after radical Nephroureterectomy have not changed significantly over the past three decades, despite staging and surgical refinements. Utilization of perioperative systemic chemotherapy in urothelial carcinoma management remains low. Further improvements in outcomes of urothelial carcinoma patients necessitate rigorous investigation of multimodal treatment approaches.

  • gender differences in radical Nephroureterectomy for upper tract urothelial carcinoma
    World Journal of Urology, 2011
    Co-Authors: Shahrokh F. Shariat, Ricardo L Favaretto, Wassim Kassouf, Amit Gupta, Hansmartin Fritsche, Kazumasa Matsumoto, Thomas J Walton, Stefan Tritschler, Shiro Baba, Kazuhito Matsushita
    Abstract:

    Purpose Women have been associated with adverse outcomes after radical cystectomy for lower tract urothelial carcinoma. We evaluated the prognostic value of gender in an international cohort of patients treated with radical Nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC).

  • comparison between laparoscopic and open radical Nephroureterectomy in a contemporary group of patients are recurrence and disease specific survival associated with surgical technique
    European Urology, 2010
    Co-Authors: Ricardo L Favaretto, Matthew Kaag, Jonathan A. Coleman, Shahrokh F. Shariat, Bernard H Bochner, Guilherme Godoy, Daher C Chade, Angel M Cronin, Guido Dalbagni
    Abstract:

    Background Open radical Nephroureterectomy (ORN) is the current standard of care for upper tract urothelial carcinoma (UTUC), but laparoscopic radical Nephroureterectomy (LRN) is emerging as a minimally invasive alternative. Questions remain regarding the oncologic safety of LRN and its relative equivalence to ORN.

  • highly predictive survival nomogram after upper urinary tract urothelial carcinoma
    Cancer, 2010
    Co-Authors: Claudio Jeldres, Shahrokh F. Shariat, Hugues Widmer, Paul Perrotte, Giovanni Lughezzani, Francesco Montorsi, Maxine Sun, Hendrik Isbarn, Markus Graefen, Pierre I Karakiewicz
    Abstract:

    BACKGROUND: Nephroureterectomy is the surgical standard of care for patients with upper urinary-tract urothelial carcinoma. The objectives of the current study were to identify the most informative predictors of cancer-specific mortality after Nephroureterectomy, to devise an algorithm capable of predicting the individual probability of cancerspecific mortality, and to compare its prognostic accuracy to that of the International Union Against Cancer (UICC) staging system. METHODS: Within the Surveillance, Epidemiology, and End Results database, the authors identified 5918 patients who had been treated with Nephroureterectomy. Within the development cohort (n ¼ 2959), multivariate Cox regression models predicting cancer-specific mortality were fitted by using age, stage, nodal status, sex, grade, race, type of surgery (Nephroureterectomy with or without bladder-cuff removal), and tumor location (renal pelvis vs ureter). Backward variable elimination according to the Akaike information criterion identified the most accurate and parsimonious model. Model validation and calibration were performed within the external validation cohort (n ¼ 2959). External validation was also applied to the UICC staging system. RESULTS: The 5-year freedom from cancer-specific mortality rates in both the development and external validation cohorts was 77.3%. The most informative and parsimonious nomogram for cancer-specific-mortality–free survival relied on age, pT and pN stages, and tumor grade. In external validation, nomogram prediction of 5-year cancer-specific-mortality–free rate was 75.4% accurate and was significantly better (P < .001) than the UICC staging system (64.8%). CONCLUSIONS: The current nomogram is capable of predicting the prognosis in patients with upper urinary-tract urothelial carcinoma treated by Nephroureterectomy with better accuracy than the UICC staging system. The authors recommend the application of this nomogram to routine clinical practice when counseling or making clinical decisions. Cancer 2010;116:3774–84. V C 2010 American Cancer Society.

Elspeth M. Mcdougall - One of the best experts on this subject based on the ideXlab platform.

  • Comparison of Hand Assisted and Standard Laparoscopic Radical Nephroureterectomy for the Management of Localized Transitional Cell Carcinoma
    The Journal of urology, 2002
    Co-Authors: Jaime Landman, R. Sherburne Figenshau, Ralph V. Clayman, Ronan Y. Lev, Sam B. Bhayani, Gregory F. Alberts, Jamil Rehman, John G. Pattaras, Adam S. Kibel, Elspeth M. Mcdougall
    Abstract:

    Purpose: Hand assisted laparoscopy affords the surgeon tactile sensation and blunt dissection, which are currently limited using the standard laparoscopic technique. Therefore, we compared standard and hand assisted laparoscopic radical Nephroureterectomy for localized upper tract transitional cell carcinoma.Materials and Methods: The medical records of 27 patients who underwent standard (11) or hand assisted (16) laparoscopic radical Nephroureterectomy between April 1998 and January 2001 were retrospectively reviewed. The parameters of efficacy, efficiency, safety and convalescence were compared.Results: Mean patient age was 64 and 66 years (p = 0.72) in the standard and hand assisted groups, and the mean American Society of Anesthesiologists score was 2.5 and 2.7 (p = 0.64), respectively. All standard and 15 of the 16 hand assisted (94%) procedures were successfully completed via laparoscopy. Total operative time was more than 1 hour shorter for hand assisted than for laparoscopic radical nephroureterec...

  • laparoscopic Nephroureterectomy for upper tract transitional cell cancer
    1999
    Co-Authors: Arieh L Shalhav, Abdelhamid M. Elbahnasy, Elspeth M. Mcdougall, Ralph V. Clayman
    Abstract:

    Standard therapy for most patients with upper-tract transitional cell carcinoma (TCC) is total Nephroureterectomy with excision of an ipsilateral cuff of bladder, performed through two separate incisions or one long abdominal incision. Laparoscopic nephrectomy is a recognized form of ablative therapy for patients with benign renal disease; recently it has been extended to the management of renal cell carcinoma and upper-tract TCC. In May 1991, the first clinical laparoscopic Nephroureterectomy (LNU) was performed at Washington University in St. Louis. Since then, a total of 20 patients with upper-tract TCC have undergone LNU at our institution. The technique begins with a transurethral unroofing and electrocoagulation of the ureteral orifice with placement of an external ureteral catheter. Next, a transperitoneal laparoscopic total or radical nephrectomy dissection is performed. Then, another 12-mm port is inserted infraumbilically and the ureter is dissected distally to the ureterovesical junction; a 12-mm laparoscopic GIA tissue stapler is fired across the bladder cuff. The specimen is placed into an entrapment sack and removed intact by enlarging one of the trocar sites to 7–10 cm. In our experience, LNU has had a short-term efficacy similar to that of open Nephroureterectomy. However, LNU required an average of 3.6h longer operative time. In favor of LNU were a 74% reduction in analgesia requirements, a brief hospital stay (average, 4 days), and a rapid convalescence (average, 2.4 weeks).

  • laparoscopic Nephroureterectomy for upper tract transitional cell cancer the washington university experience
    The Journal of Urology, 1995
    Co-Authors: Elspeth M. Mcdougall, Ralph V. Clayman, Osama M Elashry
    Abstract:

    AbstractPurpose: The recognized form of therapy for patients with ureteral or renal pelvis transitional cell carcinoma is total Nephroureterectomy with excision of the ipsilateral periureteral cuff of bladder mucosa. We report our experience with 10 patients who underwent laparoscopic Nephroureterectomy for upper tract transitional cell carcinoma through July 1994 and compare them to a contemporary group of patients undergoing open Nephroureterectomy for the same disease.Materials and Methods: A total of 10 patients undergoing laparoscopic Nephroureterectomy for upper tract transitional cell carcinoma was evaluated with respect to operative time, surgical specimen weight, pathological stage, postoperative analgesia requirement, interval to resume normal oral intake, postoperative recovery and results of postoperative surveillance. Of the patients 8 who underwent open surgical Nephroureterectomy during a contemporary period for the same diagnosis were evaluated for the same parameters and compared to the l...

  • laparoscopic Nephroureterectomy for upper tract transitional cell cancer the washington university experience commentary authors reply
    The Journal of Urology, 1995
    Co-Authors: Elspeth M. Mcdougall, Osama M Elashry, Ralph V. Clayman, Louis R. Kavoussi
    Abstract:

    Purpose : The recognized form of therapy for patients with ureteral or renal pelvis transitional cell carcinoma is total Nephroureterectomy with excision of the ipsilateral periureteral cuff of bladder mucosa. We report our experience with 10 patients who underwent laparoscopic Nephroureterectomy for upper tract transitional cell carcinoma through July 1994 and compare them to a contemporary group of patients undergoing open Nephroureterectomy for the same disease. Materials and Methods : A total of 10 patients undergoing laparoscopic Nephroureterectomy for upper tract transitional cell carcinoma was evaluated with respect to operative time, surgical specimen weight, pathological stage, postoperative analgesia requirement, interval to resume normal oral intake, postoperative recovery and results of postoperative surveillance. Of the patients 8 who underwent open surgical Nephroureterectomy during a contemporary period for the same diagnosis were evaluated for the same parameters and compared to the laparoscopic group. Results : Laparoscopic Nephroureterectomy averaged twice as long as open Nephroureterectomy. However, the laparoscopic patients resumed oral intake sooner, required less postoperative analgesia and had a shorter hospital stay compared to the open surgical group. The laparoscopic Nephroureterectomy patients returned to normal activities within less than half the time (2.8 versus 6 weeks) and completely recovered 5 times more rapidly (6 weeks versus 7.4 months). Conclusions : Laparoscopic Nephroureterectomy is a feasible treatment option for patients with upper tract transitional cell carcinoma. However, 2 major drawbacks to the approach persist, that is the lengthy operative time and the need for significant laparoscopic experience on the part of the surgeon.

Ricardo L Favaretto - One of the best experts on this subject based on the ideXlab platform.

  • renal function and oncologic outcomes of parenchymal sparing ureteral resection versus radical Nephroureterectomy for upper tract urothelial carcinoma
    The Journal of Urology, 2012
    Co-Authors: Jonathan L Silberstein, Nicholas Power, Ricardo L Favaretto, Matthew Kaag, Tatum Tarin, Caroline Savage, Harry W Herr, Daniel Su, Guido Dalbagni
    Abstract:

    Purpose: We compared renal function and oncologic outcomes of parenchymal sparing ureteral resection with radical Nephroureterectomy for the treatment of upper tract urothelial carcinoma confined to the ureter.Materials and Methods: Review of a large institutional database identified 367 patients treated for primary upper tract urothelial carcinoma with radical Nephroureterectomy or parenchymal sparing ureteral resection from 1994 to 2009. Patients with known renal pelvis tumors, muscle invasive urothelial carcinoma, prior cystectomy, contralateral upper tract urothelial carcinoma, metastatic disease or chemotherapy were excluded, leaving 120 patients for analysis. Estimated glomerular filtration rate was calculated using the Modification of Diet in Renal Disease equation. Recurrence-free, cancer specific and overall survival were estimated using Kaplan-Meier analysis.Results: Radical Nephroureterectomy was performed in 87 patients and parenchymal sparing ureteral resection in 33. Median age at surgery wa...

  • renal function and oncologic outcomes of parenchymal sparing ureteral resection versus radical Nephroureterectomy for upper tract urothelial carcinoma
    The Journal of Urology, 2012
    Co-Authors: Jonathan L Silberstein, Nicholas Power, Ricardo L Favaretto, Matthew Kaag, Tatum Tarin, Caroline Savage, Harry W Herr, Daniel Su, Guido Dalbagni
    Abstract:

    Purpose: We compared renal function and oncologic outcomes of parenchymal sparing ureteral resection with radical Nephroureterectomy for the treatment of upper tract urothelial carcinoma confined to the ureter.Materials and Methods: Review of a large institutional database identified 367 patients treated for primary upper tract urothelial carcinoma with radical Nephroureterectomy or parenchymal sparing ureteral resection from 1994 to 2009. Patients with known renal pelvis tumors, muscle invasive urothelial carcinoma, prior cystectomy, contralateral upper tract urothelial carcinoma, metastatic disease or chemotherapy were excluded, leaving 120 patients for analysis. Estimated glomerular filtration rate was calculated using the Modification of Diet in Renal Disease equation. Recurrence-free, cancer specific and overall survival were estimated using Kaplan-Meier analysis.Results: Radical Nephroureterectomy was performed in 87 patients and parenchymal sparing ureteral resection in 33. Median age at surgery wa...

  • gender differences in radical Nephroureterectomy for upper tract urothelial carcinoma
    World Journal of Urology, 2011
    Co-Authors: Shahrokh F. Shariat, Ricardo L Favaretto, Wassim Kassouf, Amit Gupta, Hansmartin Fritsche, Kazumasa Matsumoto, Thomas J Walton, Stefan Tritschler, Shiro Baba, Kazuhito Matsushita
    Abstract:

    Purpose Women have been associated with adverse outcomes after radical cystectomy for lower tract urothelial carcinoma. We evaluated the prognostic value of gender in an international cohort of patients treated with radical Nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC).

  • comparison between laparoscopic and open radical Nephroureterectomy in a contemporary group of patients are recurrence and disease specific survival associated with surgical technique
    European Urology, 2010
    Co-Authors: Ricardo L Favaretto, Matthew Kaag, Jonathan A. Coleman, Shahrokh F. Shariat, Bernard H Bochner, Guilherme Godoy, Daher C Chade, Angel M Cronin, Guido Dalbagni
    Abstract:

    Background Open radical Nephroureterectomy (ORN) is the current standard of care for upper tract urothelial carcinoma (UTUC), but laparoscopic radical Nephroureterectomy (LRN) is emerging as a minimally invasive alternative. Questions remain regarding the oncologic safety of LRN and its relative equivalence to ORN.