Authors: Xiaohong Su Dong Fang Lei Zhang Gengyan Xiong Han Hao Guangzhi Zhao Kunlin Yang Yunchao Xing Xuesong Li Liqun Zhou
Publish Date: 2016/07/04
Volume: 48, Issue: 10, Pages: 1601-1608
Abstract
A retrospective analysis of 61 cases who underwent operation for UTUC of a solitary kidney from 2000 to 2012 was performed Radical nephroureterectomy RNU or conservative management was performed Patients were divided into three groups according to preoperative renal function group A eGFR ≥ 60 mL/min group B 15 mL/min ≤ eGFR 60 mL/min and group C eGFR 15 mL/min We analyzed treatment outcomes of patients with different renal function and surgical approachesNo significant complications were observed and shorttime recovery after operation was satisfactory in all patients The 5year cancerspecific survival CSS rates for the groups A B and C were 929 753 and 637 respectively p = 0683 The 5year overall survival OS and recurrencefree survival rates were 929 and 53 for group A respectively 753 and 648 for group B respectively and 637 and 295 for group C respectively all p 01 The conservative management arm was associated with older age p = 0002 smaller tumor size p = 0013 lack of renal replacement history p = 0007 and better preoperative renal function p = 0002 There were no significant differences in 5year CSS OS or recurrencefree survival between the RNU and conservative management groups Longterm hemodialysis was required in only three patients in the conservative management armLongterm oncological outcomes after conservative management are comparable to RNU in selected cases and conservative management should be considered an alternative treatment measure Preoperative renal function and clinicopathological characteristics are important in surgery selection for patients with UTUC of a solitary kidneyThis work was supported by grants from the Collaborative Research Foundation of Peking University Health Science Center and National Taiwan University the College of Medicine BMU20120318 the National Natural Science Foundation of China 81172419 81372746 the Natural Science Foundation of Beijing 7122183 7152146 the clinical features research of the Capital No Z151100004015173 and the Research Foundation of Peking University First Hospital No 2015QN026
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