The Recurrence Rates at Three Years for the Conservatively Managed UTUC Cases Using NBI-Assisted Flexible Ureteroscopy and Holmium Laser Vaporization
<i>Background and Objectives</i>: This study aimed to evaluate the recurrence rates at three years for upper tract urothelial carcinoma (UTUC) cases managed conservatively, using Narrow Band Imaging (NBI)-assisted flexible ureteroscopy and Holmium laser vaporization. <i>Materials a...
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2024-11-01
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| author | Petrisor Geavlete Valentin Iordache Razvan Multescu Alexandra Paunescu Cosmin Ene Razvan Popescu Catalin Bulai Bogdan Geavlete |
| author_facet | Petrisor Geavlete Valentin Iordache Razvan Multescu Alexandra Paunescu Cosmin Ene Razvan Popescu Catalin Bulai Bogdan Geavlete |
| author_sort | Petrisor Geavlete |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: This study aimed to evaluate the recurrence rates at three years for upper tract urothelial carcinoma (UTUC) cases managed conservatively, using Narrow Band Imaging (NBI)-assisted flexible ureteroscopy and Holmium laser vaporization. <i>Materials and Methods</i>: The study group included 61 patients who were diagnosed with NBI-assisted visualization with superficial pyelo-calyceal urothelial tumor lesions, treated conservatively by the flexible ureteroscopic approach and Holmium laser vaporization, also assisted by NBI. This was compared with a control group with the same number of cases, which underwent the same procedure, but without NBI technology. Recurrence rates, the rate of patients who underwent nephroureterectomy, and cancer-specific survival were compared. <i>Results</i>: The relapse rate at 1 year was 3.3% in the study group, and respectively 8.2% in the control group (<i>p</i> < 0.05). Depending on the histological characteristics, at 1 year the relapse rates in the study group were 1.8% in patients with low-grade tumors and 20% in those with high-grade tumors. At 3 years, the relapse rate was 11.5% in the study group versus 18% in the control group, (<i>p</i> < 0.05): 7.1% in patients with low-grade lesions and 40% in patients with high-grade lesions versus 21.4% in patients with low-grade lesions and 100% in patients with high-grade lesions (both arms with statistically significant differences, <i>p</i> < 0.05). Cancer-specific survival was 93.4% in the study group versus 86.9% in the control group (<i>p</i> < 0.05). <i>Conclusions</i>: The recurrence rates at three years for the UTUC cases managed conservatively, using NBI-assisted flexible ureteroscopy and Holmium laser vaporization, were lower than in patients treated by the same technique without NBI assistance, both in low- and high-grade tumors. Cancer-specific survival was also significantly improved by the association of NBI visualization during diagnosis and laser vaporization. |
| format | Article |
| id | doaj-art-da5bf338b65b404fbe14f20e16c9f23a |
| institution | DOAJ |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2024-11-01 |
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| spelling | doaj-art-da5bf338b65b404fbe14f20e16c9f23a2025-08-20T02:43:50ZengMDPI AGMedicina1010-660X1648-91442024-11-016012191110.3390/medicina60121911The Recurrence Rates at Three Years for the Conservatively Managed UTUC Cases Using NBI-Assisted Flexible Ureteroscopy and Holmium Laser VaporizationPetrisor Geavlete0Valentin Iordache1Razvan Multescu2Alexandra Paunescu3Cosmin Ene4Razvan Popescu5Catalin Bulai6Bogdan Geavlete7Department of Urology, “St. John” Emergency Clinical Hospital, Vitan-Barzesti 13, District 4, 042122 Bucharest, RomaniaDepartment of Urology, “St. John” Emergency Clinical Hospital, Vitan-Barzesti 13, District 4, 042122 Bucharest, RomaniaDepartment of Urology, “St. John” Emergency Clinical Hospital, Vitan-Barzesti 13, District 4, 042122 Bucharest, RomaniaDepartment of Pathology, “St. John” Emergency Clinical Hospital, Vitan-Barzesti 13, District 4, 042122 Bucharest, RomaniaDepartment of Urology, “St. John” Emergency Clinical Hospital, Vitan-Barzesti 13, District 4, 042122 Bucharest, RomaniaFaculty of General Medicine, “Carol Davila” University of Medicine and Pharmacy, Dionisie Lupu Street 37, District 1, 030167 Bucharest, RomaniaDepartment of Urology, “St. John” Emergency Clinical Hospital, Vitan-Barzesti 13, District 4, 042122 Bucharest, RomaniaDepartment of Urology, “St. John” Emergency Clinical Hospital, Vitan-Barzesti 13, District 4, 042122 Bucharest, Romania<i>Background and Objectives</i>: This study aimed to evaluate the recurrence rates at three years for upper tract urothelial carcinoma (UTUC) cases managed conservatively, using Narrow Band Imaging (NBI)-assisted flexible ureteroscopy and Holmium laser vaporization. <i>Materials and Methods</i>: The study group included 61 patients who were diagnosed with NBI-assisted visualization with superficial pyelo-calyceal urothelial tumor lesions, treated conservatively by the flexible ureteroscopic approach and Holmium laser vaporization, also assisted by NBI. This was compared with a control group with the same number of cases, which underwent the same procedure, but without NBI technology. Recurrence rates, the rate of patients who underwent nephroureterectomy, and cancer-specific survival were compared. <i>Results</i>: The relapse rate at 1 year was 3.3% in the study group, and respectively 8.2% in the control group (<i>p</i> < 0.05). Depending on the histological characteristics, at 1 year the relapse rates in the study group were 1.8% in patients with low-grade tumors and 20% in those with high-grade tumors. At 3 years, the relapse rate was 11.5% in the study group versus 18% in the control group, (<i>p</i> < 0.05): 7.1% in patients with low-grade lesions and 40% in patients with high-grade lesions versus 21.4% in patients with low-grade lesions and 100% in patients with high-grade lesions (both arms with statistically significant differences, <i>p</i> < 0.05). Cancer-specific survival was 93.4% in the study group versus 86.9% in the control group (<i>p</i> < 0.05). <i>Conclusions</i>: The recurrence rates at three years for the UTUC cases managed conservatively, using NBI-assisted flexible ureteroscopy and Holmium laser vaporization, were lower than in patients treated by the same technique without NBI assistance, both in low- and high-grade tumors. Cancer-specific survival was also significantly improved by the association of NBI visualization during diagnosis and laser vaporization.https://www.mdpi.com/1648-9144/60/12/1911UTUC recurrenceflexible ureteroscopyHolmium laserNBI |
| spellingShingle | Petrisor Geavlete Valentin Iordache Razvan Multescu Alexandra Paunescu Cosmin Ene Razvan Popescu Catalin Bulai Bogdan Geavlete The Recurrence Rates at Three Years for the Conservatively Managed UTUC Cases Using NBI-Assisted Flexible Ureteroscopy and Holmium Laser Vaporization Medicina UTUC recurrence flexible ureteroscopy Holmium laser NBI |
| title | The Recurrence Rates at Three Years for the Conservatively Managed UTUC Cases Using NBI-Assisted Flexible Ureteroscopy and Holmium Laser Vaporization |
| title_full | The Recurrence Rates at Three Years for the Conservatively Managed UTUC Cases Using NBI-Assisted Flexible Ureteroscopy and Holmium Laser Vaporization |
| title_fullStr | The Recurrence Rates at Three Years for the Conservatively Managed UTUC Cases Using NBI-Assisted Flexible Ureteroscopy and Holmium Laser Vaporization |
| title_full_unstemmed | The Recurrence Rates at Three Years for the Conservatively Managed UTUC Cases Using NBI-Assisted Flexible Ureteroscopy and Holmium Laser Vaporization |
| title_short | The Recurrence Rates at Three Years for the Conservatively Managed UTUC Cases Using NBI-Assisted Flexible Ureteroscopy and Holmium Laser Vaporization |
| title_sort | recurrence rates at three years for the conservatively managed utuc cases using nbi assisted flexible ureteroscopy and holmium laser vaporization |
| topic | UTUC recurrence flexible ureteroscopy Holmium laser NBI |
| url | https://www.mdpi.com/1648-9144/60/12/1911 |
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