Reply to Hao Lun Luo, Yen Ta Chen, Yuan Tso Cheng, and Po Hui Chiang's Letter to the Editor re: Re: Thomas Seisen, Benoit Peyronnet, Jose Luis Dominguez-Escrig, et al. Oncologic Outcomes of Kidney-sparing Surgery Versus Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: A Systematic Review by the EAU Non-muscle Invasive Bladder Cancer Guidelines Panel. Eur Urol 2016; 70: 1052-68 The Key Role of Flexible Ureterorenoscopy in Kidney-sparing Surgery for Upper Tract Urothelial Carcinoma
Abstract
We read with interest the letter by Luo et al providing new insights into patient selection for kidney-sparing surgery (KSS) in the treatment of upper tract urothelial carcinoma (UTUC). Using institutional data, the authors found that chronic kidney disease and history of bladder cancer were independent predictors of occult renal pelvis disease in radical nephroureterectomy (RNU) patients preoperatively diagnosed with solitary ureteral tumors.
These results suggest that KSS should be carefully considered for individuals presenting with such baseline characteristics, given the higher risk of residual disease after ureteroscopic ablation (URS) or segmental ureterectomy (SU). However, two major limitations may impact the findings of Luo et al.