Login to Access Video or Poster Abstract: MP78-03
Sources of Funding: None

Introduction

To determine the impact of residual periorifice urothelium after nephroureterectomy for primary upper tract urothelial cancer. (UTUC)_x000D_

Methods

We retrospectively reviewed patients with upper UTUC that had undergonenephroureterectomy. Of these 105 patients, 67 of which belonged to the study group with ipsilateral residual peri-ureteral orifice urothelium (RUO), while 38 patients served as controls with no residual peri-ureteral orifice urothelium (NUO) postoperatively by follow up cystoscopy. We analyzed intravesical recurrence, local recurrence, and survival to assess the significance between two groups._x000D_

Results

Baseline demographics were comparable in both groups. In comparison with the RUO group, the NUO group was associated with a longer total operative time (150±78 vs.200±115 mins, p=0.03). Bladder recurrence was observed in 40 out of 67 (59.7%) in the RUO group and in 10 out of 38 (26%) in the NUO group (p=0.001) during median 39.7 months follow up. There was a significant difference in bladder cancer recurrence-free rate in the NUO group versus RUO group (p=0.04). Fifty-four percent (24/50) of first intravesical recurrence had a tendency of recurrence occurring near the area of ipsilateral ureteral orifice/scar especially in RUO group. (57.5% vs.40 %, p= 0.04). Most patients (94%) in whom a bladder tumor developed postoperatively were superficial and underwent transurethral resection of the bladder tumor. The cancer specific survival rate was not significantly different when we compared the RUO and NUO groups (p =0.42)._x000D_ _x000D_ _x000D_

Conclusions

Residual peri-ureteral orifice urothelium increased the risk of intravesical recurrence, but did not undermine survival after nephroureterectomy for primary UTUC._x000D_

Funding

None