Commentary on Laparoscopic radical nephroureterectomy for upper tract transitional cell carcinoma: Oncological outcomes at 7 years: Berger A, Haber GP, Kamoi K, Aron M, Desai MM, Kaouk JH, Gill IS, Center for Laparoscopic and Robotic Surgery, Department o

Purpose sent long-term oncological outcomes following laparoscopic nephroureterectomy for upper tract transitional cell carcinoma. als and Methods n December 1997 and August 2005, 100 patients underwent laparoscopic nephroureterectomy for upper tract transitional cell carcinoma at our institution. Data were obtained from a prospectively maintained database, patient charts, telephone follow-up, and a review of the Social Security Death Index. s patient age at surgery was 73 years. Final pathological stage was pTis/pTa in 28% of patients, pT1 in 31%, pT2 in 13%, pT3 in 24%, and pT4 in 4%. High grade lesions were present in 58% of patients, multifocal disease was present in 23%, and lymphovascular invasion was present in 9%. Positive surgical margins occurred in 7 patients (7%). Median follow-up was 7 years (range 2–10). At 2, 5, and 7 years, overall survival was 81%, 59%, and 50%, cancer specific survival was 91%, 77%, and 72%, and recurrence-free survival was 66%, 50%, and 36%, respectively. Five-year cancer specific survival by stage was 80% for pTis/Ta, 70% for pT1, 68% for pT2, 60% for pT3, and 0% for pT4. On univariate analysis non-organ confined disease and lymphovascular invasion affected cancer specific survival (P = 0.01 and 0.04, respectively). On multivariate analysis only non-organ confined disease was a significant factor (P = 0.04). Concomitant bladder tumor at diagnosis was associated with poor recurrence-free survival on univariate and multivariate analysis (P = 0.02 and 0.01, respectively). sions knowledge, the largest long-term follow-up after laparoscopic nephroureterectomy for upper tract transitional cell carcinoma is presented. Long-term oncological outcomes appear comparable to those of open surgery.