PERCUTANEOUS MANAGEMENT OF TRANSITIONAL-CELL CARCINOMA OF THE RENAL COLLECTING SYSTEM - 9-YEAR EXPERIENCE

Purpose: We establish the effectiveness of percutaneous resection of transitional cell carcinomas of the renal collecting system. Materials and Methods: 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. Results: 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 understaging and vascular complications. Bacillus Calmette-Guerin therapy showed no significant improvement in survival. Conclusions: 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.