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Review
. 2025 Jan 1;35(1):58-67.
doi: 10.1097/MOU.0000000000001248. Epub 2024 Nov 7.

Comparison of surgical effectiveness: kidney sparing surgery for upper tract urothelial carcinoma

Hugo W Schuil  1   2 , Orlane J A Figaroa  1   2 , Joyce Baard  1   2 , David A Lifshitz  3   4 , Faridi S Jamaludin  5 , Guido M Kamphuis  1   2
Affiliations
Review

Comparison of surgical effectiveness: kidney sparing surgery for upper tract urothelial carcinoma

Hugo W Schuil et al. Curr Opin Urol. .

Abstract

Purpose of review: This review provides an overview of the recent publications on kidney-sparing-surgery (KSS) for upper tract urothelial carcinoma (UTUC), an alternative to radical nephroureterectomy (RNU) for an increasing number of indications.

Recent findings: Recent studies highlight comparable survival outcomes between KSS [ureterorenoscopy with tumour ablation (URS) or segmental ureteral resection (SUR)] and RNU, even in high-risk UTUC patients. KSS has shown to preserve renal function without significantly compromising oncologic control in appropriately selected patients. Included literature also researched surgical complications, surveillance strategies, such as second-look ureteroscopy, and comparative cost analyses.

Summary: Over the past two and a half years, studies have emphasized the growing usage of URS and SUR in treating selected UTUC patients. Recent literature has remarkably included relatively large numbers of typically high-risk patients with features such as high-grade tumours, stage >Ta, multifocality, and hydronephrosis with acceptable results. Further research should expand on the different indications for KSS, its postoperative surveillance and comparative economic analyses.

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References

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