Objective: To compare the impact onoverall survival (OS) of laparoscopic nephroureterectomy (LNU) vs open nephroureterectomy (ONU) in patients with locally advanced upper tract transitional cell carcinoma (UTTCC) (pT3-pT4).
Material And Methods: Sixty-six patients underwent LNU/ONU at our institution between March 2001 and August 2016 (36 ONU and 30 LNU) with confirmed UTTCC diagnosis. Demographic, histological and survival variables were extracted. The statistical analysis was performed using Chi-square test, Exact Ficher test,log-rank test and Cox regression analysis.
Results: The median time of follow-up was 14.3 months (Q1-Q3 6.6, 38.8). No differences were found between both groups in terms of demographic or pathology variables. The median survival time was 11.6 months (IQR 5.0- 18.2) in the ONU group and 33.8 months (IQR 2.5-65.2) in the LNU group. The 5y OS rate was 14% in the ONU group and 37% in the LNUgroup. Surgical approach, ASA or pT and the multifocality showed a statistically significant association with OS.
Conclusion: Our study shows an association between the surgical approach and OS, with increased mortality associated to the ONU.
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