Findings from a retrospective analysis show that laparoscopic nephroureterectomy can benefit patients with bladder cancer because of minimal invasiveness and comparable outcomes with open nephroureterectomy (Saudi Med J. 2020;41[1]:25-33).

“We determined the surgical and oncological outcomes of laparoscopic nephroureterectomy…in comparison to open nephroureterectomy…and factors predicting bladder recurrence after nephroureterectomy,” explained lead investigator Khalid I. Alothman, MD, Department of Urology, King Faisal Specialist Hospital & Research Centre, Riyadh, Kingdom of Saudi Arabia, and colleagues.

Thus, they retrospectively reviewed and analyzed the data of 50 patients who underwent ONU (n = 26) or LNU (n = 24) for nonmetastatic, upper-tract urothelial carcinoma between 2000 and 2016.

Dr Alothman and co-investigators used Student’s t-test, Chi-square test, and Kaplan-Meier curve to analyze study data, with primary end points of bladder cancer recurrence-free survival (BCRFS), cancer-specific survival (CSS), and overall survival (OS).

For patients who underwent laparoscopic and open nephroureterectomies, median durations of follow-up lasted for 4.2 and 6.5 years, respectively (P = .1070). Of note, surgery duration, blood loss, and length of hospital stay were significantly lower in the laparoscopic versus open nephroureterectomy arms, respectively (P = .0001; P = .0001; and P = .0018, respectively).

Rates of BCRFS and CSS were not significantly different between patients who underwent laparoscopic and open nephroureterectomies, respectively (log-rank test; BCRFS, P = .809 and CSS, P = .802).

Previous history of bladder cancer (P = .020), ureteroscopy with biopsy (P = .001), and multifocality (P = .001) were characteristics tied to a significant risk for bladder cancer recurrence postnephroureterectomy.  

“Laparoscopic nephroureterectomy can benefit patients because of its minimal invasiveness, and oncologic outcomes are comparable to [open nephroureterectomy],” concluded Dr Alothman and colleagues.

“Preoperative ureteroscopy with biopsy, multifocality and previous H/O [history of] bladder cancer might be risk factors for bladder cancer recurrence,” they added.—Hina Porcelli