Objective To evaluate the effects of preoperative ureteroscopy(URS)on the prognosis of patients with upper tract urothelial carcinoma(UTUC)after radical nephroureterectomy(RNU).Methods Data of 712 UTUC patients who received RNU in West China Hospital during May 2003 and Jun.2019 were retrospectively analyzed.Patients were divided into URS group(n=187)and non-URS group(n=525)according to whether URS was performed before RNU.Kaplan-Meier curves were used to analyze the overall survival(OS),cancer-specific survival(CSS),and intravesical recurrence-free survival(IVRFS).Cox proportional risk model was used for risk assessment.Subgroup analysis and interaction test were used to further verify the results.Results Significant differences were observed between the two groups in terms of body mass index(BMI),diabetes mellitus,surgical method,hydronephrosis,tumor location,tumor grade,lymph node metastasis,lymphovascular invasion and tumor diameter(P＜0.05).Kaplan-Meier survival analysis showed that IVRFS was significantly lower in the URS group than in the non-URS group(P＜0.001),and the difference was more pronounced in renal pelvis carcinoma(P＜0.001);there were no differences in OS and CSS between the two groups(P＞0.05).Cox multivariate regression showed that URS was an independent risk factor for intravesical recurrence(HR=2.12,95％CI:1.34-3.36,P＜0.001).Conclusion Preoperative URS can increase the recurrence rate of UTUC,but it has no effect on the OS and CSS.
维普
万方数据