Evidence map›Paper›PMID 40263168›Full record

ArticleWorld journal of urology2025

Endoscopic ablation versus nephroureterectomy in localized low-grade upper tract urothelial carcinoma: a comparison in terms of cancer-specific and other-cause mortality.

Carolin Siech, Letizia Maria Ippolita Jannello, Mario de Angelis, Francesco Di Bello, Natali Rodriquez Peñaranda, Jordan A Goyal, Zhe Tian, Fred Saad, Shahrokh F Shariat, Salvatore Micali and 8 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Carolin SiechCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montreal, QC, Canada. siech@med.uni-frankfurt.de.
Letizia Maria Ippolita JannelloCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montreal, QC, Canada.
Mario de AngelisCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montreal, QC, Canada.
Francesco Di BelloCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montreal, QC, Canada.
Natali Rodriquez PeñarandaCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montreal, QC, Canada.
Jordan A GoyalCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montreal, QC, Canada.
Zhe TianCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montreal, QC, Canada.
Fred SaadCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montreal, QC, Canada.
Shahrokh F ShariatDepartment of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Salvatore MicaliDepartment of Urology, AOU di Modena, University of Modena and Reggio Emilia, Modena, Italy.
Nicola LongoDepartment of Neuroscience, Science of Reproduction and Odontostomatology, University of Naples Federico II, Naples, Italy.
Ottavio de CobelliDepartment of Urology, IEO European Institute of Oncology, IRCCS, Milan, Italy.
Alberto BrigantiUnit of Urology, Division of Experimental Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.
Benedikt HoehDepartment of Urology, University Hospital, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
Philipp MandelDepartment of Urology, University Hospital, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
Luis A KluthDepartment of Urology, University Hospital, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
Felix K H ChunDepartment of Urology, University Hospital, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
Pierre I KarakiewiczCancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montreal, QC, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeGuidelines recommend endoscopic ablation in select upper urinary tract urothelial carcinoma (UTUC) patients. To test for differences in cancer-specific mortality (CSM) and other-cause mortality (OCM) in localized non-invasive low-grade UTUC with tumor size < 2 cm treated with endoscopic ablation vs. radical nephroureterectomy.

methodsWithin Surveillance, Epidemiology, and End Results database (2000-2020), we identified UTUC patients treated with either endoscopic ablation or radical nephroureterectomy. After propensity score matching (ratio 1:1), cumulative incidence plots, and competing risks regression models addressed CSM and OCM.

resultsOf 249 included UTUC patients, 66 (27%) were treated with endoscopic ablation vs. 183 (73%) with radical nephroureterectomy. Over the study period, endoscopic ablation use increased from 10 to 45% (p = 0.01). After 1:1 propensity score matching, 66 of 66 (100%) endoscopic ablation and 66 of 183 (36%) radical nephroureterectomy patients were included. Ten-year CSM rates were 15.7% after endoscopic ablation vs. 13.9% after radical nephroureterectomy (p = 0.9). Ten-year OCM rates were 46.3% after endoscopic ablation vs. 57.9% after radical nephroureterectomy (p = 0.5). In multivariable competing risks regression models, CSM (hazard ratio 1.10; p = 0.9) and OCM (hazard ratio 0.83; p = 0.5) did not differ according to use of endoscopic ablation vs. radical nephroureterectomy.

conclusionEndoscopic ablation of localized non-invasive low-grade UTUC with tumor size < 2 cm results in absence of cancer-control outcome differences relative to radical nephroureterectomy. This observation validates the current guideline recommendations.

Indexed as

Ablation TechniquesCarcinoma, Transitional CellKidney NeoplasmsNephroureterectomyUreteral NeoplasmsUreteroscopyAgedCause of DeathFemaleHumansMaleMiddle AgedNeoplasm GradingPropensity ScoreRetrospective StudiesCancer-specific survivalKidney-sparing managementOther-cause mortalitySEERUTUC

Identifiers

PMID40263168
PMCPMC12014723

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.