Comparison of Oncological Outcomes between Transperitoneal and Retroperitoneal Approaches in Laparoscopic Nephroureterectomies for Upper Tract Urothelial Carcinoma
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Surgical Technique
2.3. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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tLNU (n = 52) | rLNU (n = 93) | p-Value | |||
---|---|---|---|---|---|
Age, years | 76 (53–89) | 75 (43–88) | N.S. | ||
Gender, male/female | 34/18 | 66/27 | N.S. | ||
Body mass index, kg/m2 | 23.0 (16.4–42.1) | 21.9 (12.7–33.7) | |||
Smoking (%) | 20 (38%) | 43 (46%) | |||
Tumor location | |||||
Renal pelvis | 21 | 54 | |||
Ureter | 29 | 38 | |||
Renal pelvis + ureter | 2 | 1 | |||
Right/left | 19/33 | 43/50 | |||
Neoadjuvant chemotherapy | 3 | 1 | |||
Operative time, min | 294 (148–731) | 291 (143–490) | |||
Laparoscopic surgery time, min | 211 (106–402) | 170 (50–314) | <0.001 | ||
Estimated blood loss, mL | 50 (5–950) | 75 (5–720) | |||
pT stage | |||||
pT0, pTis, pTa, pT1, pT2 | 0, 3, 12, 11, 7 | 33 (63%) | 1, 15, 12, 18, 12 | 58 (62%) | |
pT3, pT4 | 18, 1 | 19 (27%) | 31, 4 | 35 (38%) | N.S. |
Location of metastasis | |||||
Lymph node | 1 | 8 | |||
Liver | 3 | 2 | |||
Bone | 1 | 2 | |||
Lung | 4 | 6 | |||
Bladder | 13 | 20 | N.S. | ||
Intrapelvic | 2 | 4 | |||
Residual ureter | 1 | 1 | |||
Adjuvant chemotherapy | 7 | 10 | |||
Months after surgery | 34 (0.4–108) | 41.3 (0.1–120) | N.S. | ||
History of bladder cancer | 12 | 9 | 0.03 | ||
tLNU (n = 43) | rLNU (n = 43) | p-Value | |||
Age, years | 76 (53–87) | 75 (54–86) | N.S. | ||
Gender, male/female | 27/16 | 31/12 | N.S. | ||
Body mass index, kg/m2 | 23.0 (16.4–42.1) | 21.9 (12.7–31.6) | |||
Smoking (%) | 17 (40%) | 17 (40%) | |||
Tumor location | |||||
Renal pelvis | 21 | 54 | |||
Ureter | 29 | 38 | |||
Renal pelvis + ureter | 2 | 1 | |||
Right/left | 17/26 | 20/23 | |||
Neoadjuvant chemotherapy | 3 | 1 | |||
Operative time, min | 279 (148–731) | 293 (143–490) | |||
Laparoscopic surgery time, min | 200 (105–370) | 170 (79–314) | <0.001 | ||
Estimated blood loss, mL | 45 (5–950) | 50 (5–720) | |||
pT stage | |||||
pT0, pTis, pTa, pT1, pT2 | 0, 3, 11, 10, 7 | 31 (72%) | 1, 8, 6, 11, 6 | 32 (74%) | |
pT3, pT4 | 11, 1 | 12 (28%) | 9, 2 | 11 (26%) | N.S. |
Location of metastasis | |||||
Lymph node | 1 | 5 | |||
Liver | 2 | 1 | |||
Bone | 1 | 1 | |||
Lung | 3 | 2 | |||
Bladder | 12 | 11 | N.S. | ||
Intrapelvic | 2 | 1 | |||
Residual ureter | 1 | 1 | |||
Adjuvant chemotherapy | 5 | 4 | |||
Months after surgery | 33.3 (0.4–108) | 42.8 (0.1–115) | N.S. | ||
History of bladder cancer | 11 | 3 | 0.02 | ||
N.S.: not significant |
Univariate | Multivariate | |||||
---|---|---|---|---|---|---|
HR | 95%CI | p-Value | HR | 95%CI | p-Value | |
Female vs. male | 1.35 | 0.76–2.33 | 0.28 | |||
Age ≥ 75 vs. <75 | 1.02 | 0.98–1.05 | 0.21 | |||
Smoking | 1.21 | 0.49–1.43 | 0.5 | |||
Surgical approach (retro- vs. transperitoneal) | 1.03 | 0.599–1.83 | 0.91 | |||
pT3≥ vs. pT2≤ | 2.09 | 1.21–3.56 | 0.01 | 2.31 | 1.33–3.99 | 0.01 |
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Otoshi, T.; Yamasaki, T.; Matsue, T.; Yukimatsu, N.; Kato, M.; Machida, Y.; Iwai, T.; Kuratsukuri, K.; Uchida, J. Comparison of Oncological Outcomes between Transperitoneal and Retroperitoneal Approaches in Laparoscopic Nephroureterectomies for Upper Tract Urothelial Carcinoma. Medicina 2024, 60, 421. https://doi.org/10.3390/medicina60030421
Otoshi T, Yamasaki T, Matsue T, Yukimatsu N, Kato M, Machida Y, Iwai T, Kuratsukuri K, Uchida J. Comparison of Oncological Outcomes between Transperitoneal and Retroperitoneal Approaches in Laparoscopic Nephroureterectomies for Upper Tract Urothelial Carcinoma. Medicina. 2024; 60(3):421. https://doi.org/10.3390/medicina60030421
Chicago/Turabian StyleOtoshi, Taiyo, Takeshi Yamasaki, Taisuke Matsue, Nao Yukimatsu, Minoru Kato, Yuichi Machida, Tomoaki Iwai, Katsuyuki Kuratsukuri, and Junji Uchida. 2024. "Comparison of Oncological Outcomes between Transperitoneal and Retroperitoneal Approaches in Laparoscopic Nephroureterectomies for Upper Tract Urothelial Carcinoma" Medicina 60, no. 3: 421. https://doi.org/10.3390/medicina60030421