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01-11-2019 | Cystectomy | Urology - Review

Organ-sparing procedures in GU cancer: part 3-organ-sparing procedures in urothelial cancer of upper tract, bladder and urethra

Authors: Mahmoud I. Khalil, Jeffrey T. Alliston, Jonathan J. Bauer-Erickson, Rodney Davis, Nabil K. Bissada, Mohamed H. Kamel

Published in: International Urology and Nephrology | Issue 11/2019

Abstract

Purpose

The impact of radical surgery for urothelial carcinoma is significant on patient’s quality of life. Organ-sparing surgery (OSS) can provide comparable oncological outcomes and with improved quality of life. In this review, we summarize the indications, techniques and outcomes of OSS for these tumors.

Methods

PubMed^® was searched for relevant articles. Keywords used were: for upper tract urothelial carcinoma (UTUC): endoscopic, ureteroscopic/percutaneous management, laser ablation; for urothelial bladder cancer: bladder preservation, trimodal therapy, muscle invasive bladder cancer (MIBC); for urethral cancer: urethra/penile-sparing, urethral carcinoma.

Results

Kidney-sparing surgery is an option in patients with low-risk UTUC with better renal function preservation and comparable oncological control to radical nephroureterectomy. In select patients with MIBC, trimodal therapy has better quality of life and comparable oncological control to radical cystectomy. In distal male urethral cancer, penile conserving surgery is feasible and offers acceptable survival outcomes. In female urethral cancer, organ preservation can be achieved, in addition to OSS, through radiation.

Conclusions

In the appropriately selected patient, OSS in upper tract, bladder and urethral carcinoma has comparable oncological outcomes to radical surgery and with the additional benefit of improved quality of life.

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Title: Organ-sparing procedures in GU cancer: part 3-organ-sparing procedures in urothelial cancer of upper tract, bladder and urethra
Authors: Mahmoud I. Khalil
Jeffrey T. Alliston
Jonathan J. Bauer-Erickson
Rodney Davis
Nabil K. Bissada
Mohamed H. Kamel
Publication date: 01-11-2019
Publisher: Springer Netherlands
Keywords: Cystectomy
Radiotherapy
Urethral Carcinoma
Urethral Carcinoma
Urothelial Cancer
Urothelial Cancer
Cytostatic Therapy
Laser
Published in: International Urology and Nephrology / Issue 11/2019
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI: https://doi.org/10.1007/s11255-019-02232-z

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