Impact of tumour location and surgical approach on recurrence-free and cancer-specific survival analysis in patients with ureteric tumours

OBJECTIVE • To assess the impact of tumour location within the ureter and the impact of surgical approach on recurrence-free survival (RFS) and cancer-specific survival (CSS) with regard to ureteric tumours. PATIENTS AND METHODS • Data were retrospectively reviewed from 60 patients with isolated primary ureteric tumours, treated at a single tertiary referral centre. • Patients were treated with radical nephroureterectomy (NU, n = 33), partial ureterectomy ( n = 17) or endoscopic resection (ENDO, n = 10). • Kaplan - Meier curves were used for the analysis of RFS and CSS after surgery, stratified by tumour location and surgical approach. RESULTS • With a median follow-up of 29 months, tumour location was not associated with disease recurrence ( P = 0.423). • The ENDO group had shorter time to disease recurrence. • There were no significant differences in the probability of CSS with regard to either tumour location or surgical approach ( P = 0.523 and P = 0.904, respectively). CONCLUSIONS • Tumour location or surgical approach were not significant predictors of oncological outcomes in patients with ureteric tumours. • Although NU is standard treatment for invasive ureteric tumours, partialureterectomy and ENDO can safely be performed in selected patients. Despite the risk of a shorter time to recurrence, ENDO can be recommended in low grade, non-invasive ureteric tumours. • All urothelium-preserving approaches require thorough surveillance.