ND-YAG LASER TREATMENT IN TRANSITIONAL-CELL CARCINOMA OF THE UPPER URINARY-TRACT

Six patients with upper urinary tract tumors were treated in our department with the Nd:-YAG laser between 1989 and 1993. The average follow-up was 23.8 months. The mean age of the patients was 65.7 years. The patients were selected for organ-conserving treatment because of bilateral synchronous tumors (2 cases), a solitary renal unit (2 cases), renal insufficiency with high surgical risk (1 case) and high surgical risk alone (1 case). Two patients were treated with open tumor excision and laser, two patients with ureteroscopic and percutaneous procedures one patient with percutaneous treatment and one patient with ureteroscopy. Two patients underwent nephroureterectomy; one of them died of metastatic bladder cancer 9 months later. Local relapses were observed in one patient who had been treated endoscopically. In a follow-up period of 6-36 months there were three patients who had no relapses. Three patients received intracavitary therapy. Kidney conserving procedures with the Nd:-YAG laser in patients with upper urinary tract tumors should be reserved for highly selected cases.