Ureteroscopy in the Diagnosis of Upper Tract Transitional Cell Cancer: A 10-Year Experience Providing Outcome Data for Informed Consent. Issue 4 (October 2017)

• Record Type: Journal Article
• Authors: Hanna, Luke; Chung, Vera; Ali, Ahmed; Ritchie, Robert; Rogers, Ann; Sullivan, Mark; Keoghane, Stephen
• Is Part Of: Urologia journal. Volume 84:Issue 4(2017)
• Page Start: 254
• Page End: 258
• Publication Date: 2017-10
• Subjects: Diagnostic -- Transitional cell carcinoma -- Ureteroscopy -- Urothelial carcinoma; Urology -- Periodicals; 616.6005
• DOI: 10.5301/uj.5000241
• Languages: English
• ISSNs: 0391-5603

Abstract

Purpose: The aim of the study was to assess the effectiveness of ureteroscopy and biopsy in the diagnosis and management of upper tract urothelial carcinoma. Methods: We retrospectively collated data from pathology, radiology and operating theatre data sets from two large UK hospitals. During the 10-year period examined, 160 patients underwent ureteroscopy prior to nephro-ureterectomy (NU)/distal ureterectomy (DU). Results: Of the 160 patients identified, 140 were ureteroscopically evaluated and biopsied, 104 (74.3%) had positive biopsies, 5 (3.6%) had negative biopsies and 31 (22.1%) had nondiagnostic biopsies. One hundred and forty patients of 160 (88.8%) resulted in positive findings as a result of their ureteroscopy [positive biopsy/positive operative cytology/visible upper tract urothelial carcinoma (UTUC) at ureteroscopy)]. A total of 108 patients had cytological samples sent for histological analysis where grade was able to be assessed at DU/NU. Of these samples, 35 had positive cytology, 58 had an abnormal result that was not diagnostic and 15 had negative cytology. Patients with positive biopsies had upstaging (58.4%) and/or upgrading (30.5%) of their initial ureteroscopic histology at NU/DU. The overall success rate of ureteroscopy for cancer diagnosis was 88.8%. Conclusions: Upper tract endoscopy and biopsy yielded positive biopsy results in 74.3% of cases and confirmed a cancer diagnosis in 88.8%. Five patients had negative histology at biopsy, all of whom eventually underwent a NU/DU confirming cancer.