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Kidney-Sparing Surgery Found Safe and Effective for Some Patients with Upper Tract Urothelial Cancer

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Kidney-Sparing Surgery Found Safe and Effective for Some Patients with Upper Tract Urothelial Cancer

Upper tract urothelial carcinoma (UTUC) is a type of cancer that affects the inner lining of the kidney and ureter. The usual treatment is radical nephroureterectomy (RNU), a surgery that removes the entire kidney and ureter. While this approach removes the cancer, it can also reduce kidney function.

A new study has reviewed data from more than 33,000 patients to compare two surgical options—RNU and a less invasive operation called segmental ureterectomy (SU). SU removes only the part of the ureter that contains the tumour, keeping the rest of the kidney intact.

The results showed that both surgeries provided similar cancer control. Survival rates, including five-year cancer-specific survival and overall survival, were almost the same for both groups. This means that removing only the affected part of the ureter did not increase the risk of cancer returning or spreading.

The major difference was in kidney function. Patients who had the kidney-sparing surgery (SU) had better kidney function one year after surgery. Their kidneys filtered blood more effectively, and they were less likely to experience kidney damage over time.

These findings suggest that SU can be a safe and effective choice for patients with low-risk UTUC and for some carefully selected high-risk patients. Preserving kidney function is especially important for people with only one kidney or those at risk of kidney disease.

Doctors emphasize the need for long-term follow-up and more studies, but this approach offers real hope for patients who want effective cancer treatment without losing kidney function.

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