ArticleTranslational andrology and urology2026
Recurrence and timing of conversion to radical nephroureterectomy after endoscopic laser ablation for upper tract urothelial carcinoma: a multicenter Japanese study.
Article in Translational andrology and urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Laser ablation is a kidney-sparing treatment option for upper tract urothelial carcinoma; however, evidence regarding oncological outcomes, particularly in high-risk diseases, remains limited. This study aimed to highlight the clinical and oncological features and survival outcomes of Japanese patients with upper tract urothelial carcinoma who underwent endoscopic laser ablation. Methods: We retrospectively reviewed 34 patients with upper tract urothelial carcinoma who underwent endoscopic laser ablation. Upper tract recurrence- and metastasis-free survival were estimated using Kaplan-Meier curves and compared using the log-rank test. Cox proportional hazards models were used to identify preoperative prognostic factors associated with upper tract recurrence-free survival (RFS). Advanced pathology at subsequent radical nephroureterectomy (RNU) was defined as stage ≥ pT3 and/or lymph node involvement. Results: According to the European Association of Urology risk stratification, 9 patients (26%) were classified as low risk and 25 (74%) as high risk. High-risk patients had significantly poorer upper tract RFS. In multivariable analysis, high risk was independently associated with worse upper tract RFS (hazard ratio: 9.02; 95% confidence interval: 1.18-68.8). Upper tract recurrence occurred in 77% of high-risk patients; 48% underwent RNU, and advanced pathological features were identified in 50%. The median interval from initial recurrence to RNU was longer in patients with advanced pathology (17.5 Conclusions: High-risk patients with upper tract urothelial carcinoma treated with laser ablation had a significant upper tract recurrence risk, and half of those requiring delayed RNU had advanced pathological disease. Prolonged endoscopic management after recurrence may increase pathological upstaging risk, underscoring the importance of early and careful consideration of conversion to RNU.
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