Management of Upper Tract Urothelial Carcinoma
Asaf Shvero1,2,3, Scott G Hubosky4
1Department of Urology, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Thomas Jefferson University, 1025 Walnut Street, Suite 1100, Philadelphia, PA, 19107, USA.
Purpose Of Review:
We review the epidemiology, risk factors, diagnosis, and treatment of upper tract urothelial carcinoma (UTUC), with a distinction between the different risk groups.
Recent Findings:
Endoscopic treatment with laser ablation of tumors has an evolving role in treating low-grade UTUC including select large and multifocal tumors, along with complementary topical chemotherapeutic treatment that can reach difficult intrarenal locations. Template lymphadenectomy is recommended in patients undergoing nephroureterectomy. A recent randomized control trial showed benefit of adjuvant chemotherapy after radical nephroureterectomy for locally advanced disease. Advances in immunologic therapy have shown promise in treating metastatic UTUC, and immunologic-based therapies have been incorporated into treatment regimens. Notable progress has been made in both the surgical and medical treatment arms for UTUC, thus extending the reach of nephron-sparing therapy for those with localized disease and increasing overall survival for those with locally advanced disease.
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