{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T13:09:21Z","timestamp":1788786561634,"version":"build-2803163510"},"reference-count":33,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Objectives: To investigate the rate and predictors of recurrence at second-look ureterorenoscopy (URS) and to assess the adequate timeframe for second-look URS in upper tract urothelial carcinoma (UTUC). Methods: This multicenter retrospective study included 179 patients who underwent endoscopic kidney-sparing surgery (KSS) and second-look URS for non-invasive UTUC between 2004 and 2017. We performed logistic and Cox proportional hazard regression analyses to investigate the association between clinical parameters and second-look recurrence, recurrence-free survival (RFS), and cancer-specific mortality. The optimal duration to second-look URS was extrapolated using restricted cubic splines. Results: Overall, 66 (36.9%) patients experienced recurrence at second-look URS. After second-look URS, further recurrence was observed in 87 (48.6%) patients during a median follow-up of 12 months. Female gender (OR [odds ratio] 2.3, 95% CI [confidence interval] 1.1\u20134.7, p = 0.026) and tumor size &gt; 1 cm (OR 3.3, 95% CI 1.2\u20139.5, p = 0.027) were independently associated with recurrence at second look. Second-look recurrence was a strong prognostic factor for RFS (HR 5.0, 95% CI 3.1\u20138.0, p &lt; 0.001). Second-look URS between 5 and 12 weeks after initial endoscopic laser ablation was an independent favorable factor for RFS (HR 0.5, 95% CI 0.3\u20130.9, p = 0.014). Conclusions: Early recurrence at second-look URS appears to be one of the strongest predictive factors for RFS in patients undergoing endoscopic KSS. Our results suggest that second-look URS performed within 5 to 12 weeks is associated with a lower probability of further disease recurrence. Given that this interval was derived and tested in the same cohort, this finding should be regarded as hypothesis-generating and requires external validation before being adopted as a clinical standard.<\/jats:p>","DOI":"10.3390\/cancers18172893","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T12:12:25Z","timestamp":1788783145000},"page":"2893","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Role of Second-Look Ureterorenoscopy After Endoscopic Treatment of Upper Tract Urothelial Carcinoma"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6603-6319","authenticated-orcid":false,"given":"Mohammad","family":"Abufaraj","sequence":"first","affiliation":[{"name":"Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman 11942, Jordan"},{"name":"Department of Urology, Comprehensive Cancer Center Vienna, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7864-408X","authenticated-orcid":false,"given":"Beat","family":"Foerster","sequence":"additional","affiliation":[{"name":"Department of Urology, Comprehensive Cancer Center Vienna, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Department of Urology, Kantonsspital Winterthur, 8400 Winterthur, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6965-389X","authenticated-orcid":false,"given":"Tim","family":"Muilwijk","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospitals Leuven, 3000 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1806-1448","authenticated-orcid":false,"given":"Gautier","family":"Marcq","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, McGill University Health Center, Montreal, QC H4A 0B1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Thomas","family":"Seisen","sequence":"additional","affiliation":[{"name":"Department of Urology, Sorbonne University, GRC n\u00b05, ONCOTYPE-URO, AP-HP, Urology, H\u00f4pital Piti\u00e9-Salp\u00eatri\u00e8re, F-75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Roger","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL 33612, 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Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Francesco","family":"Soria","sequence":"additional","affiliation":[{"name":"Department of Urology, Comprehensive Cancer Center Vienna, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Division of Urology, Department of Surgical Sciences, University of Studies of Torino, 10124 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Giuseppe","family":"Fallara","sequence":"additional","affiliation":[{"name":"Department of Urology, Urological Research Institute, Vita-Salute University, San Raffaele Scientific Institute, 20132 Milan, 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Sechenov First Moscow State Medical University, 119991 Moscow, Russia"},{"name":"Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA"},{"name":"Department of Urology, Weill Cornell Medical College, New York, NY 10065, USA"},{"name":"Karl Landsteiner Institute of Urology and Andrology, 1090 Vienna, Austria"},{"name":"Department of Urology, Second Faculty of Medicine, Charles University, 150 06 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.eururo.2017.07.036","article-title":"European Association of Urology Guidelines on Upper Urinary Tract Urothelial Carcinoma: 2017 Update","volume":"73","author":"Roupret","year":"2018","journal-title":"Eur. 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