The pathogenesis and management of urothelial malignancies

Urothelial malignancies are frequently encountered among elderly persons. Host susceptibility and the presence of urothelial carcinogens are of primary importance in the development of these cancers. The natural history of these cancers produces a spectrum of disease processes with varying tendencies regarding invasion, spread, and multicentric origin. Consequently, a multitude of treatment options exist for the clinician and patient dealing with urothelial tumors. Essential to the reduction of morbidity and mortality attributable to these malignancies is the elimination of known risk factors, coupled with prompt diagnosis and treatment. Finally, the high propensity for these tumors to recur necessitates an aggressive cancer surveillance program in the patient population at risk.