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Objective: The coronavirus disease-2019 pandemic has shown us that postponing elective surgeries that include nephrectomy due to renal cell carcinomas (RCC) was undertaken by the physicians to use hospital facilities in a balanced way. However, both urologists and patients were concerned about postponements that may increase the risk of progression. To determine the optimal threshold of postponement time-period for surgery (PTP) and according to the clinical T stages in patients who underwent nephrectomy due to RCC, we used the Urologic Cancer Database-Kidney. Materials and Methods: Patients who underwent detailed clinical T stage analysis with admission and surgery dates were included in the study. PTP was calculated using the dates of definitive preoperative diagnosis and surgery date. Recurrence, overall mortality (OM), recurrence-free survival, and overall survival (OS) were evaluated. The effects of PTP on oncological outcome according to tumor diameter and clinical T stages were also evaluated. We also analyzed the optimal cut-offs of PTP based on clinical T stages. Results: Among 3.258 patients, in the evaluation of 2.946 clinically localized patients, PTP and tumor diameter were found to be important predictors of recurrence (p=0.037 and p<0.001). The optimal PTP of 30 days was found to be an important significant threshold time for the T1 stage and 20 days for T2-4 stage tumors. Patients with longer PTP according to the thresholds shown in this study had higher upstaging for clinical T1a, T2a, and T3 stages; higher recurrence rates for T1b and T2b stages; and higher OM for T2a and T3 tumors. The survival have also shown that more than 20 days of PTP affected OSs for clinical-stage T1 (p=0.019), T2 (p=0.021) and T3 (p=0.007) tumors. Conclusions: All patients with tumors, including clinical T1 tumors, had worsening oncological results as the PTP increased (>20-30 days). [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate the factors affecting intravesical recurrence and survival in patients undergoing radical nephroureterectomy and bladder cuff excision due to primary upper urinary system urothelial tumor (UUST) in our clinic. Materials and Methods: The data of 52 patients who were operated for primary UUST between 2008 and 2018 were retrospectively evaluated. All patients underwent preoperative computed tomography and magnetic resonance urography. Tumor localizations were grouped according to the ureteropelvic compound. During the follow-up period after radical surgery, the patients underwent physical examination, routine blood tests and radiological evaluation. The patients were followed up quarterly in the first two years, every six months for the next two years and then yearly with cystoscopy. Results: Thirteen female and 39 male patients with an average age of 60.5±10.35 years were included in the study. Mean follow-up time was 66.8±38.2 months. Thirty (58%) patients had renal tumors, 13 (25%) patients had ureteral tumors and 9 (17%) patients had multifocal tumors. Intravesical recurrence was detected in 9 (69%) patients with ureteral tumor (p=0.047). Ten-year overall survival of patients with ureteral tumors was 50% (35.4% side effect) (Log rank test=0.012). Recurrent-free survival was significantly worse in ureteral tumors (Hazard ratio:3, p=0.04). Conclusion: The ureteral tumor group was significantly worse in terms of postoperative intravesical recurrence and overall survival and recurrence-free survival. [ABSTRACT FROM AUTHOR]

Purpose: To compare the quality of life (QoL) of renal cancer patients following laparoscopic and open radical nephrectomy. Materials and Methods: Seventy-two (64.9%) patients who were treated with open radical nephrectomy (ORN group) and 39 (35.1%) patients who were treated with laparoscopic radical nephrectomy (LRN group) were included in this study. QoL was evaluated by Short Form-36 (SF-36) physical domain scores obtained before surgery, 1 and 6 months after surgery. Analgesic requirement and visual analog scale (VAS) pain scores following surgeries were recorded. Results: The demographic features of the groups were similar. There was a significant difference in tumor size between the ORN group (71.59 ± 29.83 mm) and LRN group (57.08 ± 19.33 mm) (P = .011). In the LRN group there was less blood loss, a lower transfusion rate, earlier ambulation, more rapid convalescence and shorter hospitalization; however, the difference in surgical duration between the ORN group (122.86 ± 36.8 min) and LRN group (140.17 ± 50.71 min) was not significant (P = .383). Analgesic requirement and VAS pain scores were similar in both groups. In terms of SF-36 physical domain scores, the general health perception score in the LRN group was higher than that in the ORN group at pre-surgery, 1 and 6 months after surgery. SF-36 physical functioning and general health perception scores in both groups were significantly lower in 1 month after surgery and were higher in 6 months after surgery, as compare to before surgery. Bodily pain scores in LRN group did not change significantly after surgery (P = .376). Conclusion: LRN exhibited some technical advantages, including less blood loss, shorter hospitalization and more rapid recovery. Although the ORN patients had relatively larger tumors, analgesic requirement, postoperative complications, body pain, and physical functioning weren't significantly different between the groups. QoL was higher 6 months after surgery than before surgery in both groups. [ABSTRACT FROM AUTHOR]