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Less Invasive Surgery Shows Better Survival in Patients with Upper Tract Urothelial Cancer in Taiwan

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Less Invasive Surgery Shows Better Survival in Patients with Upper Tract Urothelial Cancer in Taiwan

Upper tract urothelial carcinoma (UTUC) is a rare cancer worldwide but is much more common in Taiwan, where it makes up about one-third of all urothelial cancers. The standard treatment is radical nephroureterectomy (RNU), which means removing the kidney, ureter, and part of the bladder. Traditionally, this surgery has been done with an open approach, but minimally invasive surgery (MIS), including laparoscopic and robotic techniques, is becoming more common.

Some patients and doctors worry that less invasive surgery might not control the cancer as well as open surgery. To answer this question, researchers in Taiwan studied more than 2,400 patients with UTUC who underwent surgery between 1988 and 2022. After carefully matching patients to make the groups similar, they compared survival outcomes between those who had open surgery and those who had MIS.

The results were encouraging. Patients who had MIS lived longer overall and also had better cancer-specific survival and disease-free survival compared with those who had open surgery. These benefits were seen even though many patients in the MIS group had more aggressive cancers.

This study shows that minimally invasive techniques, when performed carefully with proper removal of the bladder cuff, can be just as effective—if not more effective—than open surgery. Patients may also benefit from quicker recovery, less pain, and smaller scars, making MIS an appealing option.

For patients in Taiwan and elsewhere with UTUC, this research supports the use of minimally invasive surgery as a safe and effective choice. Discussing surgical options with an experienced urologist can help determine the best approach.

DOI: 10.1007/s00345-025-05829-5

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