Percutaneous management of transitional cell carcinoma of the renal collecting system: 9-year experience.

Abstract

We establish the effectiveness of percutaneous resection of transitional cell carcinomas of the renal collecting system. A retrospective analysis was done of 36 kidneys treated during a 9-year period. Adjunctive therapy with bacillus Calmette-Guerin was given in 19 cases. Of 36 kidneys 6 were treated by immediate nephroureterectomy for aggressive disease, leaving 30 units treated by a complete course. The recurrence rate was 33%, which varied with histology as specific recurrence rates for grades 1 to 3 tumors (18%, 33% and 50%, respectively). The only cancer related mortalities occurred with grade 3 tumors. These tumors also had a higher incidence of understanding and vascular complications. Bacillus Calmette-Guerin therapy showed no significant improvement in survival. With vigilant followup, percutaneous management of transitional cell carcinoma of the renal collecting system is an acceptable alternative to nephroureterectomy in patients with grade 1 disease, grade 2 disease who are at risk for renal insufficiency and medical contraindications to a major open operation.