Endoscopic management of upper-tract urothelial carcinoma

ABSTRACT

Introduction: Radical nephroureterectomy with an ipsilateral bladder cuff is the referent standard for management of muscle-invasive, high-grade, or bulky upper-tract urothelial carcinoma (UTUC). Nonetheless, certain patients with UTUC have imperative or elective indications for kidney preservation thereby lending to more conservative strategies for management of this disease.

Areas covered: A review of the PubMED and Medline databases was performed to identify original scientific and review articles discussing retrograde ureteroscopic or percutaneous antegrade resection of UTUC tumors published between 1995 and 2016. Comparative studies with radical nephroureterectomy were also included.

Expert commentary: Endoscopic ablative treatments via retrograde or antegrade approaches may appropriately treat small, solitary, and low risk UTUC tumors. Recurrences in the ipsilateral upper-tract and bladder distal to the original tumor can occur following nephron-sparing treatments and therefore a vigilant surveillance program with a compliant patient is essential when pursuing this treatment approach.

KEYWORDS:

• Urothelial cancer
• kidney preservation
• endoscopic ablation
• ureteroscopy
• percutaneous

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

No funding received