Long-term outcome of endoscopic biopsy and subsequent nephroureterectomy for upper urinary tract tumor

Background: Upper urinary tract tumors can be biopsied using a flexible ure terorenoscope. This study examined retrospectively possible adverse effects of this procedure on patient outcome. Methods: The study subjects consisted of 16 consecutive patients with renal pelvic tumor (n = 13) and upper ureteral tumor (n = 3). All subjects under went endoscopic biopsy of their tumor and subsequent total nephroureterecto my between 1989 and 1995. The follow-up period ranged from 4.1 to 9.5 (mean 5.2) years. Results: The overall 5-year survival rate was 87.0%, being 100% in 12 patie nts with tumors of grade 1 or 2. In contrast, of four patients with grade 3 tumor. three (75%) developed systemic lymphogenous and/or multiple lung me tastases within 1 year postoperatively. Conclusions: The excellent patient outcomes deny any adverse effect of endo scopic biopsy on patients with grade 1 or 2 tumor. However, the endoscopic procedure should be performed prudently when a high grade tumor is suspecte d.