Nephrology Medical News about Endoscopic management; nephroureterectomy; upper tract urothelial carcinoma

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Endoscopic management of upper tract urothelial carcinoma
Advances in Urology, 07/15/09

Moore K et al. - In a review of endoscopic management of upper tract urothelial carcinoma, it is essential that pts are motivated and compliant as lifetime follow-up is necessary. Until large randomized trials with long-term follow-up are performed, endoscopic management cannot be considered a standard treatment and should be limited to poor performance status patients.

Methods

Nephroureterectomy is currently the gold standard for management of upper urinary tract urothelial carcinoma despite it results.
The ultimate aim of endoscopic management of this condition is cancer control whilst preserving renal function and integrity of the urinary tract.
Endoscopic treatments of upper tract TCC include the antegrade percutaneous and retrograde ureteroscopic approaches.

Results

This article summarizes endoscopic management of upper tract urothelial carcinoma, surveillance of the disease after endoscopic management, and adjuvant therapy.
The main message regarding endoscopic management of upper tract urothelial cancer is that pts must be carefully selected.
Pt selection is based on tumour size, grade, and multifocality.
Single low-grade tumours <1.5 cm in size generally have a good outcome with endoscopic treatment provided that they have regular ureteroscopic surveillance.
Ureteroscopic treatment of high-grade tumours is essentially palliative.

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