Percutaneous management of grade II upper urinary tract transitional cell carcinoma: The long-term outcome

Purpose: We report the long-term outcome of our experience with percutaneou s treatment of grade II upper urinary tract transitional cell carcinoma. Materials and Methods: A total of 61 patients with transitional cell carcin oma of the upper urinary tract were treated percutaneously between 1984 and 1998. Of the patients 24 (39%) had grade II disease. Immediate nephrourete rectomy was performed due to muscle invasive disease in 2 patients, bleedin g in 1 and inability to resect the whole tumor in 1. Percutaneous resection was the actual treatment in 15 patients with stage Ta and 5 with stage T1 disease. Results: Recurrence was noted in 5 patients (25%), including 3 (20%) with s tage Ta tumors and 2 (40%) with stage T1 disease after a median followup of 48 months (range 9 months to 12 years). All stage Ta disease recurrences w ere superficial. In 1 patient with a stage T1 tumor invasive and metastatic disease developed. Disease specific survival was 95% overall, and 100% for stage Ta and 80% for stage T1 disease. No tumor seeding was detected along the percutaneous tract. Conclusions: Percutaneous surgery has proved safe and effective in treating superficial grade II upper tract transitional cell carcinoma. Offering an endoscopic approach electively to healthy individuals with a normal contral ateral kidney seems viable.