Urothelial-cell carcinoma and solitary kidney

Outcomes with renal-sparing management

John E. Milner, Bryan B. Voelzke, Robert C. Flanigan, Sameer K. Sharma, Kent T. Perry, Thomas M T Turk*

*Corresponding author for this work

Research output: Contribution to journalReview article

5 Citations (Scopus)

Abstract

Purpose: To review our experience with renal-sparing approaches for upper-tract transitional-cell carcinoma (UT-TCC) associated with solitary kidneys. Patients and Methods: Ten patients with UT-TCC associated with solitary kidneys who were managed with renal-sparing approaches from 2000 to 2004 were identified. Patient data were gathered retrospectively, and a patient interview was conducted. A literature review was performed, and our results were compared with those from selected other authors. The mean follow-up was 33 months. Results: Eight patients (80%) developed recurrence after initial treatment necessitating further intervention. The average number of procedures was nine per patient, and an average of two cycles of topical therapy was given. At the end of the follow-up period, 6 patients (60%) were disease free. Of these 6 patients, 2 (33%) required interval nephroureterectomy because of disease progression in one and renal insufficiency leading to dialysis in the other. Metastatic disease occurred in four patients during the surveillance interval, including one patient with a nephrostomy-site recurrence. Three patients died from their disease during the follow-up period, and one patient remained alive after chemotherapy. The overall survival rate was 70% at 33 months. Of the living patients, 6 (86%) could be reached for comment, and all were very satisfied with their renal-sparing management. Conclusions: Renal-sparing approaches remain an option in motivated patients with solitary kidneys and UT-TCC. Patients should realize that management tends to involve multiple procedures that are associated with potential morbidity, entails lifetime follow-up, and often requires long-term nephrostomy access for topical treatment or relief of obstruction. Long-term patient quality-of-life and cancer-specific outcomes for renal-sparing management compared with quality-of-life and survival on dialysis are unknown.

Original languageEnglish (US)
Pages (from-to)800-807
Number of pages8
JournalJournal of Endourology
Volume20
Issue number10
DOIs
StatePublished - Oct 1 2006

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Carcinoma
Kidney
Transitional Cell Carcinoma
Dialysis
Quality of Life
Recurrence
Renal Insufficiency
Disease Progression
Therapeutics
Survival Rate
Interviews
Morbidity
Drug Therapy
Survival

ASJC Scopus subject areas

  • Urology

Cite this

Milner, J. E., Voelzke, B. B., Flanigan, R. C., Sharma, S. K., Perry, K. T., & Turk, T. M. T. (2006). Urothelial-cell carcinoma and solitary kidney: Outcomes with renal-sparing management. Journal of Endourology, 20(10), 800-807. https://doi.org/10.1089/end.2006.20.800
Milner, John E. ; Voelzke, Bryan B. ; Flanigan, Robert C. ; Sharma, Sameer K. ; Perry, Kent T. ; Turk, Thomas M T. / Urothelial-cell carcinoma and solitary kidney : Outcomes with renal-sparing management. In: Journal of Endourology. 2006 ; Vol. 20, No. 10. pp. 800-807.
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title = "Urothelial-cell carcinoma and solitary kidney: Outcomes with renal-sparing management",
abstract = "Purpose: To review our experience with renal-sparing approaches for upper-tract transitional-cell carcinoma (UT-TCC) associated with solitary kidneys. Patients and Methods: Ten patients with UT-TCC associated with solitary kidneys who were managed with renal-sparing approaches from 2000 to 2004 were identified. Patient data were gathered retrospectively, and a patient interview was conducted. A literature review was performed, and our results were compared with those from selected other authors. The mean follow-up was 33 months. Results: Eight patients (80{\%}) developed recurrence after initial treatment necessitating further intervention. The average number of procedures was nine per patient, and an average of two cycles of topical therapy was given. At the end of the follow-up period, 6 patients (60{\%}) were disease free. Of these 6 patients, 2 (33{\%}) required interval nephroureterectomy because of disease progression in one and renal insufficiency leading to dialysis in the other. Metastatic disease occurred in four patients during the surveillance interval, including one patient with a nephrostomy-site recurrence. Three patients died from their disease during the follow-up period, and one patient remained alive after chemotherapy. The overall survival rate was 70{\%} at 33 months. Of the living patients, 6 (86{\%}) could be reached for comment, and all were very satisfied with their renal-sparing management. Conclusions: Renal-sparing approaches remain an option in motivated patients with solitary kidneys and UT-TCC. Patients should realize that management tends to involve multiple procedures that are associated with potential morbidity, entails lifetime follow-up, and often requires long-term nephrostomy access for topical treatment or relief of obstruction. Long-term patient quality-of-life and cancer-specific outcomes for renal-sparing management compared with quality-of-life and survival on dialysis are unknown.",
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Urothelial-cell carcinoma and solitary kidney : Outcomes with renal-sparing management. / Milner, John E.; Voelzke, Bryan B.; Flanigan, Robert C.; Sharma, Sameer K.; Perry, Kent T.; Turk, Thomas M T.

In: Journal of Endourology, Vol. 20, No. 10, 01.10.2006, p. 800-807.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Urothelial-cell carcinoma and solitary kidney

T2 - Outcomes with renal-sparing management

AU - Milner, John E.

AU - Voelzke, Bryan B.

AU - Flanigan, Robert C.

AU - Sharma, Sameer K.

AU - Perry, Kent T.

AU - Turk, Thomas M T

PY - 2006/10/1

Y1 - 2006/10/1

N2 - Purpose: To review our experience with renal-sparing approaches for upper-tract transitional-cell carcinoma (UT-TCC) associated with solitary kidneys. Patients and Methods: Ten patients with UT-TCC associated with solitary kidneys who were managed with renal-sparing approaches from 2000 to 2004 were identified. Patient data were gathered retrospectively, and a patient interview was conducted. A literature review was performed, and our results were compared with those from selected other authors. The mean follow-up was 33 months. Results: Eight patients (80%) developed recurrence after initial treatment necessitating further intervention. The average number of procedures was nine per patient, and an average of two cycles of topical therapy was given. At the end of the follow-up period, 6 patients (60%) were disease free. Of these 6 patients, 2 (33%) required interval nephroureterectomy because of disease progression in one and renal insufficiency leading to dialysis in the other. Metastatic disease occurred in four patients during the surveillance interval, including one patient with a nephrostomy-site recurrence. Three patients died from their disease during the follow-up period, and one patient remained alive after chemotherapy. The overall survival rate was 70% at 33 months. Of the living patients, 6 (86%) could be reached for comment, and all were very satisfied with their renal-sparing management. Conclusions: Renal-sparing approaches remain an option in motivated patients with solitary kidneys and UT-TCC. Patients should realize that management tends to involve multiple procedures that are associated with potential morbidity, entails lifetime follow-up, and often requires long-term nephrostomy access for topical treatment or relief of obstruction. Long-term patient quality-of-life and cancer-specific outcomes for renal-sparing management compared with quality-of-life and survival on dialysis are unknown.

AB - Purpose: To review our experience with renal-sparing approaches for upper-tract transitional-cell carcinoma (UT-TCC) associated with solitary kidneys. Patients and Methods: Ten patients with UT-TCC associated with solitary kidneys who were managed with renal-sparing approaches from 2000 to 2004 were identified. Patient data were gathered retrospectively, and a patient interview was conducted. A literature review was performed, and our results were compared with those from selected other authors. The mean follow-up was 33 months. Results: Eight patients (80%) developed recurrence after initial treatment necessitating further intervention. The average number of procedures was nine per patient, and an average of two cycles of topical therapy was given. At the end of the follow-up period, 6 patients (60%) were disease free. Of these 6 patients, 2 (33%) required interval nephroureterectomy because of disease progression in one and renal insufficiency leading to dialysis in the other. Metastatic disease occurred in four patients during the surveillance interval, including one patient with a nephrostomy-site recurrence. Three patients died from their disease during the follow-up period, and one patient remained alive after chemotherapy. The overall survival rate was 70% at 33 months. Of the living patients, 6 (86%) could be reached for comment, and all were very satisfied with their renal-sparing management. Conclusions: Renal-sparing approaches remain an option in motivated patients with solitary kidneys and UT-TCC. Patients should realize that management tends to involve multiple procedures that are associated with potential morbidity, entails lifetime follow-up, and often requires long-term nephrostomy access for topical treatment or relief of obstruction. Long-term patient quality-of-life and cancer-specific outcomes for renal-sparing management compared with quality-of-life and survival on dialysis are unknown.

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U2 - 10.1089/end.2006.20.800

DO - 10.1089/end.2006.20.800

M3 - Review article

VL - 20

SP - 800

EP - 807

JO - Journal of Endourology

JF - Journal of Endourology

SN - 0892-7790

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