{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T16:52:24Z","timestamp":1778863944181,"version":"3.51.4"},"reference-count":18,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,11,24]],"date-time":"2021-11-24T00:00:00Z","timestamp":1637712000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the long\u2010term oncological outcomes of patients with upper tract urothelial carcinoma (UTUC) undergoing radical nephroureterectomy (RNU) and the impact of diagnostic ureteroscopy (URS) on survival outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective analysis of all consecutive patients undergoing RNU for suspected UTUC at a UK tertiary referral centre from a prospectively maintained database was conducted. The primary outcome measures were 5\u2010 and 10\u2010year cancer\u2010specific survival (CSS). The secondary outcomes were: overall survival (OS), recurrence\u2010free survival (RFS), impact of prior diagnostic URS on OS, CSS and intravesical RFS (intravesical\u2010RFS), and predictors of intravesical recurrence. Statistical analysis was performed in R using the \u2018survminer\u2019 and \u2018survival\u2019 packages. The Kaplan\u2013Meier method was used to calculate survival functions and these were expressed in graphical form. Uni\u2010\/multivariate survival analyses were performed using the Cox proportional hazard regression model. Statistical significance in this study was set at\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 422 patients underwent RNU with confirmed UTUC. The median (interquartile range) follow\u2010up of patients with confirmed UTUC was 9.2 (5.6\u201312.7)\u2009years. The 5\u2010 and 10\u2010year CSS rates were 70.5% (95% confidence interval [CI] 65.9\u201374.9) and 67.1% (95% CI 62.4\u201371.6), respectively. OS (HR 1.04 [95% CI 0.78\u20131.38];\n                      <jats:italic>P<\/jats:italic>\n                      = 0.46) and CSS (HR 0.96 [95% CI 0.68\u20131.34];\n                      <jats:italic>P<\/jats:italic>\n                      = 0.81) were similar in the diagnostic URS and the direct RNU cohorts. intravesical RFS was superior for the direct RNU cohort (HR 1.94 [95% CI 1.19\u20133.17];\n                      <jats:italic>P<\/jats:italic>\n                      = 0.008). In multivariate analysis, prior URS, T2 stage, proximal ureter tumour and bladder cancer history were predictors of metachronous bladder recurrence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This single\u2010centre retrospective cohort study reports the long\u2010term oncological outcomes of RNU with a median follow\u2010up of 9.2\u2009years, serving as a reference standard in counselling patients undergoing RNU. Stage and grade of the RNU specimen were the only two studied factors that appeared to adversely impact long\u2010term CSS and OS. Our results suggest that the risk of intravesical recurrence is increased nearly twofold in patients who have undergone diagnostic URS prior to RNU. Prior URS, however, does not appear to adversely impact long\u2010term CSS and OS. The authors suggest that a risk\u2010stratified approach be adopted, wherein diagnostic URS is offered only in equivocal cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.15627","type":"journal-article","created":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T07:56:04Z","timestamp":1635839764000},"page":"744-751","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Ten\u2010year survival outcomes after radical nephroureterectomy with a risk\u2010stratified approach using prior diagnostic ureteroscopy: a single\u2010institution observational retrospective cohort study"],"prefix":"10.1111","volume":"129","author":[{"given":"Rajan","family":"Veeratterapillay","sequence":"first","affiliation":[{"name":"Freeman Hospital  Newcastle 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