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자료유형
학술저널
저자정보
류현수 (성균관대학교) 김준규 (삼성서울병원) 김태진 (삼성서울병원) 강민용 (삼성서울병원) 전황균 (성균관대학교) 정병창 (성균관대학교) 서성일 (성균관대학교) 전성수 (삼성서울병원) 이현무 (성균관대학교) 성현환 (성균관대학교)
저널정보
대한암학회 Cancer Research and Treatment Cancer Research and Treatment 제53권 제3호
발행연도
2021.1
수록면
795 - 802 (8page)

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Purpose This study aimed to evaluate the effects of bladder cuff method on oncological outcomes in patients who underwent radical nephroureterectomy (RNU) for upper tract urothelial carcinoma.Materials and Methods The records of 1,095 patients treated with RNU performed at our hospital between 1994 and 2018 were retrospectively reviewed; 856 patients with no bladder tumor history were enrolled in the present study. The management of bladder cuff was divided into two categories: extravesical ligation (EL) or transvesical resection (TR). Survival was analyzed using the Kaplan-Meier method and Cox regression analyses were performed to determine which factors were associated with intravesical recurrence (IVR)?free survival (IVRFS), cancer-specific survival (CSS), and overall survival (OS).Results The mean patient age was 64.8 years and the median follow-up was 37.7 months. Among the 865 patients, 477 (55.7%) underwent the TR and 379 (44.3%) the EL. Significantly higher IVRFS (p=0.001) and OS (p=0.013) were observed in the TR group. In multivariable analysis, IVR, CSS, and OS were independently associated with the EL. Among 379 patients treated with the EL, eight underwent remnant ureterectomy. Based on radical cystectomy?free survival, significant difference was not observed between the two groups. However, significantly higher IVRFS was observed in the TR group when the tumor was located in the renal pelvis.Conclusion Intramural complete excision of the distal ureter during RNU should be the gold standard approach compared with EL for the management of distal ureter in terms of oncological outcomes.

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