Expert on radical nephroureterectomy vs kidney-sparing surgery in UTUC

In this video, Saum B. Ghodoussipour, MD, shares the background and key findings from the study, “Comparative outcomes of radical nephroureterectomy and kidney-sparing surgery in the treatment of high-grade upper tract urothelial carcinoma,” which was presented at the 2024 ASCO Genitourinary Cancers Symposium in San Francisco, California. Ghodoussipour is an assistant professor of surgery in urologic oncology as well as the director of the bladder and urothelial cancer program at Rutgers Cancer Institute of New Jersey.

Video Transcript:

We were able to look at our institutional dataset and compare patients who had kidney-sparing surgery, or endoscopic ablation, for high-grade upper tract urothelial carcinoma to those who had radical nephroureterectomy. We looked at a 5-year experience at our institution of 105 patients treated with kidney-sparing surgery or radical nephroureterectomy. With 2 years of follow-up, we saw that there was no difference in these 2 groups in terms of overall survival, metastasis-free survival, or recurrence-free survival, meaning we can get similar cancer outcomes in patients who are well selected for kidney-sparing surgery. An important consideration for patients who are deciding between these 2 treatment approaches is what the burden of treatment is going to be for them. Patients who had kidney-sparing surgery can expect in the first year to have a higher number of procedures. In our cohort, it was about 3.5 procedures in that first year compared to 2 if you had radical surgery. Now, total anesthesia time was similar in both groups at about 400 minutes if you look at combining all the surgeries together. The days spent in the hospital was very similar as well; it was about 5 days. But the complication rate was much higher. In patients who had radical surgery, it was up to 40% vs in those who had kidney-sparing surgery was about 1%. Costs are also important to consider, and costs were slightly higher in those who had radical surgery.

This transcription has been edited for clarity.