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Genetic Differences Between Bladder and Upper Urinary Tract Carcinoma: Implications for Therapy.

John P Sfakianos1, Zeynep Gul1, Shahrokh F Shariat2

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Summary
This summary is machine-generated.

Bladder and upper tract urothelial carcinomas share some genetic mutations but differ in frequency and expression subtypes. These distinct genomic features suggest tailored therapy for each cancer type.

Keywords:
BladderGeneticsRenal pelvisSystemic therapyUreterUrothelial carcinoma

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Area of Science:

  • Genitourinary oncology
  • Cancer genomics
  • Urothelial carcinoma research

Background:

  • Bladder urothelial carcinoma (BUC) and upper tract urothelial carcinoma (UTUC) exhibit genetic variations impacting treatment strategies.
  • Understanding these genetic differences is crucial for developing targeted therapies.

Purpose of the Study:

  • To review and synthesize the current genetic understanding of UTUC and BUC.
  • To highlight the genetic similarities and differences between these two cancer types.

Main Methods:

  • Systematic literature search of PubMed, Cochrane, and Web of Science databases up to February 2020.
  • Keywords included urothelial carcinomas, upper urinary tract, renal pelvis, ureter, bladder cancer, and genetics.

Main Results:

  • UTUC and BUC share mutations in genes like FGFR3, TP53, HRAS, and epigenetic genes (KDM6A, KMT2A-C) with varying frequencies.
  • Both cancers show similar expression subtypes, but UTUC is more frequently luminal with T-cell depletion.
  • Clonal studies suggest distinct origins for metachronous recurrences (BUC after UTUC is luminal; UTUC after BUC is basal).

Conclusions:

  • UTUC and BUC share genomic alterations but differ in frequency, influencing their behavior and recurrence patterns.
  • These genetic distinctions necessitate treating UTUC and BUC as related but separate entities.
  • Genomic features can guide tailored treatment options for urothelial carcinomas based on tumor location.