NEW TECHNIQUES FOR THE ADMINISTRATION OF TOPICAL ADJUVANT THERAPY AFTER ENDOSCOPIC ABLATION OF UPPER URINARY TRACT TRANSITIONAL CELL CARCINOMA

No AccessJournal of UrologyClinical Urology: Original Articles1 Jan 1998NEW TECHNIQUES FOR THE ADMINISTRATION OF TOPICAL ADJUVANT THERAPY AFTER ENDOSCOPIC ABLATION OF UPPER URINARY TRACT TRANSITIONAL CELL CARCINOMA Anup Patel and Gerhard J. Fuchs Anup PatelAnup Patel More articles by this author and Gerhard J. FuchsGerhard J. Fuchs More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)64015-1AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated the role of combining ureteroscopic tumor ablation and new methods of administering topical adjuvant therapy in select patients with transitional cell carcinoma of the upper urinary tract. Materials and Methods: Patients with upper tract transitional cell carcinoma and indications for preserving renal function initially underwent ureteroscopic evaluation and tumor ablation. We treated 17 renal units in 13 patients. Three patients with distal ureteral lesions underwent uncomplicated adjuvant bacillus Calmette-Guerin therapy by the combination of Double-J* Medical Engineering Corp., New York, New York. stent placement and bladder instillations in the Trendelenburg position. In the remaining 14 renal units adjuvant topical therapy was administered by low pressure weekly instillations through a transvesical single-J stent whose curl was positioned in an upper calix. Patients were regularly followed with office flexible ureterorenoscopy under local anesthesia and cytology washing once they were confirmed to be tumor-free. Results: Complete ureteroscopic tumor ablation was possible in all patients. Two sessions were needed due to tumor burden in 3 patients. There were intercurrent urinary infectious complications with Candida albicans in the 3 patients treated with bacillus Calmette-Guerin through the single-J stent, including 1 who received only 3 instillations due to persistent unexplained fevers but who remains disease-free at 24 months. In 2 of the 17 renal units multifocal tumor recurred within 12 months, which was treated with nephroureterectomy. At short followup (mean 14.6 months) 15 renal units have been preserved and remain tumor-free. Conclusions: The new techniques of administering adjuvant topical agents for upper tract transitional cell carcinoma after ureteroscopic tumor ablation in select cases described provide a useful and simple alternative to the percutaneous method preferred in the past. Short-term responses have been favorable but the true value of adjuvant therapy remains uncertain at present. 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Google Scholar From the Department of Urology, UCLA Medical Center, Los Angeles, CaliforniaAccepted for publication June 27, 1997© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byWilliams N, Barnard L, Allender C, Bowen J, Gumbleton M, Harrah T, Raja A and Joshi H (2015) Evidence of Nonuniformity in Urothelium Barrier Function between the Upper Urinary Tract and BladderJournal of Urology, VOL. 195, NO. 3, (763-770), Online publication date: 1-Mar-2016.YOSSEPOWITCH O, LIFSHITZ D, DEKEL Y, EHRLICH Y, GUR U, MARGEL D, LIVNE P and BANIEL J (2018) ASSESSMENT OF VESICOURETERAL REFLUX IN PATIENTS WITH SELF-RETAINING URETERAL STENTS: IMPLICATIONS FOR UPPER URINARY TRACT INSTILLATIONJournal of Urology, VOL. 173, NO. 3, (890-893), Online publication date: 1-Mar-2005. Volume 159Issue 1January 1998Page: 71-75 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.MetricsAuthor Information Anup Patel More articles by this author Gerhard J. Fuchs More articles by this author Expand All Advertisement PDF downloadLoading ...