Tags

Type your tag names separated by a space and hit enter

Thulium-Holmium:YAG Duo laser in conservative upper tract urothelial cancer treatment: 13 years-experience from a tertiary national referral center.
J Endourol 2019JE

Abstract

Introduction and Objectives To evaluate ablative safety and efficacy of Thulium-Holmium:YAG Duo laser in renal conservative retrograde intra-renal surgery (RC-RIRS) in upper tract urothelial carcinoma (UTUC). Materials and Methods A retrospective study was performed on 178 consecutive patients referred for consideration of RC-RIRS UTUC-eLA (endoscopic laser ablation) in a tertiary center (January 2005 to December 2018). Key data were recorded using a standardized study proforma. Results After endo-diagnostic procedure, 42 declined rigorous endosurveillance (ES) protocol and went elsewhere for alternative treatment, leaving 136 patients of whom 35 patients who dropped out (25.7%) after undergoing primary radical nephroureterectomy (RNU) (unsuitable for renal preservation). This left 101 candidates continued UTUC conservative management (Intention-to-treat [ITT] population). Mean follow-up (FU) for these 101 patients was 28.7 months. At last FU (Range 3 - 144 mo.), 70 patients (69.3%) were recurrence-free, 22 (21.8%) had endoscopically treated recurrences, and a further 9 (8.9%) had undergone RNU. In the ITT population, kidney preserving rate (KPR) was 91%, while in imperative indications, it was 87.5%. Clavien Dindo grade I complications only (self-limiting hematuria) were reported in 10 %. Conclusions Over a thirteen year period, RC-RIRS UTUC treatment with the Thulium-Holmium:YAG Duo laser was safe and oncologically non-inferior to alternative combination laser energy technologies used for this indication .

Authors+Show Affiliations

Rome, Italy; defidio@tin.it."Cristo Re" General Hospital, dept. of urology, via delle Calasanziane 25, Roma, RM, Italy, 00167; mic.antonucci@yahoo.it.Ospedale Cristo Re, Urology, Via delle calasanziane, 25, Rome, Italy, 00167; dedominicism@alice.it.Cedars-Sinai Medical Center, Minimally Invasive Urology Institute, 8635 W 3rd Street, Suite 930 E, Los Angeles, California, United States, 90048; Gerhard.fuchs@med.usc.edu.Spire Roding, Urology, Roding Lane South, London, United Kingdom of Great Britain and Northern Ireland, IG4 5PZ; anuppatel666@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31422699

Citation

Defidio, Lorenzo, et al. "Thulium-Holmium:YAG Duo Laser in Conservative Upper Tract Urothelial Cancer Treatment: 13 Years-experience From a Tertiary National Referral Center." Journal of Endourology, 2019.
Defidio L, Antonucci M, De Dominicis M, et al. Thulium-Holmium:YAG Duo laser in conservative upper tract urothelial cancer treatment: 13 years-experience from a tertiary national referral center. J Endourol. 2019.
Defidio, L., Antonucci, M., De Dominicis, M., Fuchs, G., & Patel, A. (2019). Thulium-Holmium:YAG Duo laser in conservative upper tract urothelial cancer treatment: 13 years-experience from a tertiary national referral center. Journal of Endourology, doi:10.1089/end.2019.0308.
Defidio L, et al. Thulium-Holmium:YAG Duo Laser in Conservative Upper Tract Urothelial Cancer Treatment: 13 Years-experience From a Tertiary National Referral Center. J Endourol. 2019 Aug 17; PubMed PMID: 31422699.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Thulium-Holmium:YAG Duo laser in conservative upper tract urothelial cancer treatment: 13 years-experience from a tertiary national referral center. AU - Defidio,Lorenzo, AU - Antonucci,Michele, AU - De Dominicis,Mauro, AU - Fuchs,Gerhard, AU - Patel,Anup, Y1 - 2019/08/17/ PY - 2019/8/20/entrez JF - Journal of endourology JO - J. Endourol. N2 - Introduction and Objectives To evaluate ablative safety and efficacy of Thulium-Holmium:YAG Duo laser in renal conservative retrograde intra-renal surgery (RC-RIRS) in upper tract urothelial carcinoma (UTUC). Materials and Methods A retrospective study was performed on 178 consecutive patients referred for consideration of RC-RIRS UTUC-eLA (endoscopic laser ablation) in a tertiary center (January 2005 to December 2018). Key data were recorded using a standardized study proforma. Results After endo-diagnostic procedure, 42 declined rigorous endosurveillance (ES) protocol and went elsewhere for alternative treatment, leaving 136 patients of whom 35 patients who dropped out (25.7%) after undergoing primary radical nephroureterectomy (RNU) (unsuitable for renal preservation). This left 101 candidates continued UTUC conservative management (Intention-to-treat [ITT] population). Mean follow-up (FU) for these 101 patients was 28.7 months. At last FU (Range 3 - 144 mo.), 70 patients (69.3%) were recurrence-free, 22 (21.8%) had endoscopically treated recurrences, and a further 9 (8.9%) had undergone RNU. In the ITT population, kidney preserving rate (KPR) was 91%, while in imperative indications, it was 87.5%. Clavien Dindo grade I complications only (self-limiting hematuria) were reported in 10 %. Conclusions Over a thirteen year period, RC-RIRS UTUC treatment with the Thulium-Holmium:YAG Duo laser was safe and oncologically non-inferior to alternative combination laser energy technologies used for this indication . SN - 1557-900X UR - https://www.unboundmedicine.com/medline/citation/31422699/Thulium-Holmium:YAG_Duo_laser_in_conservative_upper_tract_urothelial_cancer_treatment:_13_years-experience_from_a_tertiary_national_referral_center L2 - https://www.liebertpub.com/doi/full/10.1089/end.2019.0308?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -