Objective The aim of this study was to analyse the results regarding survival, recurrence and kidney preservation after endoscopic treatment for upper urinary tract urothelial carcinoma (UTUC) in a Norwegian hospital during the period from 2001 to 2012, and compare them with results reported in the literature. A further aim was to re-examine all initial histopathological specimens, and stratify primary results according to the World Health Organization/International Society of Urological Pathology grading system of urothelial carcinoma from 2004. Materials and methods Forty-three patients were treated endoscopically with curative intent for UTUC during 2001-2012. Of these, 28 patients were candidates for nephroureterectomy (CNU) with an elective indication, while 15 were non-candidates for nephroureterectomy (NCNU). Analyses were performed separately for the CNU and NCNU groups. Results In the CNU group, the 5 year overall and disease-specific survival (OS and DSS) were 71% and 94%, respectively. In the NCNU group, the OS and DSS were 25% and 41%, respectively. Histopathological verification was available in 40 patients (93%), and re-examination showed 27 low-grade and 13 high-grade tumours. In patients with a low-grade tumour, the OS and DSS were 75% and 96%, respectively. In patients with a high-grade tumour, the OS and DSS were 23% and 39%, respectively. The 5 year kidney protection rate was 51% in the CNU group. The 5 year recurrence-free survival was 72%. Conclusions The endoscopic treatment of UTUC is feasible and safe in histopathologically verified low-grade tumours. The endoscopic treatment of high-grade tumours has poor results, and must be reserved for patients where nephroureterectomy is truly contraindicated.
Keywords: Percutaneous renal surgery; upper urinary tract; ureteroscopy; urological oncology; urothelial cancer.