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논문 기본 정보

자료유형
학술저널
저자정보
저널정보
대한암학회 Cancer Research and Treatment Cancer Research and Treatment 제51권 제3호
발행연도
2019.1
수록면
963 - 972 (10page)

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Purpose The purpose of this study was to compare oncologic outcomes between open nephroureterectomy (ONU) and laparoscopic nephroureterectomy (LNU) in patients with upper tract urothelial carcinoma. Materials and Methods The medical records of consecutive ONU and LNU cases from five tertiary institutions were retrospectively analyzed between 2000 and 2012. The propensity-score matching methodology was used to compare the two surgical approaches in terms of age, body mass index, American Society of Anesthesiologists score, tumor location, grade, pathologic T and N categories, the presence of lymphovascular invasion, and follow-up duration. The Kaplan-Meier with log-rank tests and clustered Cox regression were used to compare the estimated rates of survival for each surgical approach and to investigate the effect of the surgical approach on each prognostic outcome. Results Six hundred thirty-eight propensity-score matching pairs (n=1,276) were compared; LNU was significantly better than ONU in all types of survival, including intravesical recurrencefree survival (IVRFS), disease-free survival, overall survival (OS), and cancer-specific survival (CSS) (p < 0.05). The 3-year OS and CSS rates were significantly higher with LNU than with ONU (p < 0.05). Compared with ONU, LNU had significantly better 3-year OS and CSS rates (82.9% and 86.2% vs. 78.3% and 81.8%); there were no differences at 5 years. In subgroup analysis of the early-staged group, advanced-stage group, lymph node–positive group, and lymph node–negative group, the two approaches did not significantly affect prognostic outcomes, except LNU improved the IVRFS in the lymph node–negative or no history of previous bladder cancer group. Conclusion LNU had a significantly better prognostic outcome than ONU after propensity-score matching.

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참고문헌 (22)

참고문헌 신청
Liang C / 2016 / Upper tract urothelial carcinomas accompanied by previous or synchronous nonmuscle-invasive bladder cancer and preoperative hydronephrosis might have worse oncologic outcomes after radical nephroureterectomy / Clin Genitourin Cancer 14:e469~e477 google schola Raman JD / 2007 / Management of patients with upper urinary tract transitional cell carcinoma / Nat Clin Pract Urol 4:432~443 google schola Ariane MM / 2012 / Assessment of oncologic control obtained after open versus laparoscopic nephroureterectomy for upper urinary tract urothelial carcinomas(UUT-UCs) : results from a large French multicenter collaborative study / Ann Surg Oncol 19:301~308 google schola Peyronnet B / 2019 / Oncological outcomes of laparoscopic nephroureterectomy versus open radical nephroureterectomy for upper tract urothelial carcinoma : an European Association of Urology guidelines systematic review / Eur Urol Focus 5:205~223 google schola Epstein JI / 1998 / The World Health Organization/International Society of Urological Pathology consensus classification of urothelial (transitional cell) neoplasms of the urinary bladder. Bladder Consensus Conference Committee / Am J Surg Pathol 22:1435~1448 google schola

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