Discussed August 18th, 2006 - MP 14-18 Recurrence of upper tract transitional cell carcinoma (UTTCC) in renal units treated with percutaneous resection – 20 year experience. A. R. Rastinehad, M. C. Ost, K. R., Greenbereg, B. A. VanderBrink, B. R. Lee, G. H. Badlani, and A. D. Smith

The Institute of Urology at the North Shore LIJ Health System, New Hyde Park, NY, U.S.A.

MP 14-19

Renal preservation in upper tract transitional cell carcinoma (UTTCC) in renal units treated with percutaneous resection – 20 year experience. A. R. Rastinehad, M. C. Ost, K. R., Greenberg, B. A. VanderBrink, B. R. Lee, G. H. Badlani, and A. D. Smith

The Institute of Urology at the North Shore LIJ Health System, New Hyde Park, NY, U.S.A.

Together these two abstracts represent the most authoritative experience with the percutaneous approach to upper tract transitional cell cancer. With a mean follow-up of 5 years, both renal preservation and recurrence were similar among 88 patients, despite the grade of the tumor: Grade 1 (19 cases): 84% and 30%, Grade 2 (30 cases): 83% and 35%, and Grade 3 (39 cases): 85% and 39%. Of interest, the use of BCG did NOT cause a statistically significant decrease in upper tract recurrence rates and hence the authors do not recommend its use. It is especially of interest that the recurrence rate for Grade 1 was not statistically significantly different from recurrence rates for Grade 2 or 3. Of note, there is no mention of tract seeding. While the authors stipulate that they specifically selected patients who were not candidates for a nephroureterectomy, the results raise the question of whether the indications for this approach should be expanded. Also, the reader is cautioned that similar follow-up in as large a cohort does not yet exist for use of a ureteroscopic approach to upper tract transitional cell carcinoma. Hopefully these data will also soon be forthcoming from our ureteroscopic centers.

Written by Ralph V. Clayman, MD, a Contributing Editor with UroToday.

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