The Impact of II-look Ureteroscopy on Survival in Upper Tract Urothelial Carcinoma : A Multicenter Retrospective Study of EAU-YAU Urothelial Working Group
Gallioli, Andrea (Universitat Autònoma de Barcelona)
Di Bello, Francesco (University of Naples Federico II (Itàlia))
Laukhtina, Ekaterina (Medical University of Vienna)
D'Andrea, David (Medical University of Vienna)
Beltrami, Paolo (University of Padua (Itàlia))
Celso, Francesco Gabriele (University of Padua (Itàlia))
Krajewski, Wojciech (Wroclaw Medical University)
Afferi, Luca (Luzerner Kantonsspital (Suïssa))
Soria, Francesco (Azienda Ospedaliero Universitaria Città della Salute e della Scienza (Torí, Itàlia))
Marcq, Gautier (Claude Huriez Hospital)
Del Giudice, Francesco (Fundació Puigvert)
de Lorenzis, E. (University of Milan)
Moschini, Marco (IRCCS San Raffaele Hospital (Milà, Itàlia))
Mari, Andrea (Azienda Ospedaliero Universitaria Careggi (Florència, Itàlia))
Subiela, José Daniel (Hospital Universitario Ramón y Cajal (Madrid))
Baboudjian, Michael (North Academic Hospital. AP-HM)
Avesani, Giulio (IRCCS San Raffaele Hospital (Milà, Itàlia))
Territo, Angelo (Fundació Puigvert)
Basile, Giuseppe (Fundació Puigvert)
Diéguez, Lucía (Fundació Puigvert)
Izquierdo, Paula (Fundació Puigvert)
Palou, Juan (Institut de Recerca Sant Pau)
Pradere, Benjamin (Urosud La Croix du Sud Hospital)
Breda, Alberto (Universitat Autònoma de Barcelona. Departament de Cirurgia)
Universitat Autònoma de Barcelona. Departament de Cirurgia

Fecha:	2026
Resumen:	Background and objective: No previous study quantified the survival outcomes of second-look ureteroscopy (SU). We hypothesized that patients who underwent SU might exhibit better survival outcomes than their no-SU counterparts. Methods: We relied on a multicenter retrospective database including 358 patients with UTUC treated conservatively between 2010 and 2021. Endpoints, namely overall survival (OS) and radical nephroureterectomy (RNU) rates, modeled as competing event for other-cause mortality (OCM), were quantified. Cancer-specific mortality (CSM), and OCM were also quantified according to SU. Inverse probability of treatment weighting (IPTW) methodology was used to assess OS. Landmark analysis for OS at 2 mo was also performed. Key findings: Based on a median follow-up of 32 mo (interquartile range 16-56), 291 patients with UTUC were identified. Of those, 148 (51%) underwent SU. Median OS in patients who underwent SU was 103 versus 66 mo in patients without SU (D = 37 mo; p = 0. 0024). RNU rates did not differ among the groups (24 vs 21%, p = 0. 8). In IPTW-adjusted multivariable Cox regression models, adjusted number of lesions, tumor size, age, UTUC site, Charlson Comorbidity Index, high-grade, cytology, and ureteroscopy indication, SU patients were associated with higher OS rates compared to those without SU (hazard ratio 0. 59, 95% confidence interval 0. 37-0. 94; p = 0. 02). Within tumor ≤10 mm, four (3%) UTUC recurred in the first 9 mo of follow-up. Conclusions and clinical implications: Within the current study, SU ensured an optimal clinical decision-making. Specifically, CSM and OCM rates of SU patients and their counterparts not receiving SU validated the patients with UTUC selection for conservative treatment.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Ureteroscopy ; Outcome ; Upper urinary tract ; Endoscopy ; Laser ablation
Publicado en:	European Urology Open Science, Vol. 88 (June 2026) , p. 31-38, ISSN 2666-1683

DOI: 10.1016/j.euros.2026.03.008

8 p, 1.0 MB

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Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut de Recerca Sant Pau
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