We review the epidemiology, risk factors, diagnosis, and treatment of upper tract urothelial carcinoma (UTUC), with a distinction between the different risk groups.
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.
Current oncology reports. 2022 Feb 25 [Epub ahead of print]
Asaf Shvero, Scott G Hubosky
Department of Urology, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Thomas Jefferson University, 1025 Walnut Street, Suite 1100, Philadelphia, PA, 19107, USA., Department of Urology, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Thomas Jefferson University, 1025 Walnut Street, Suite 1100, Philadelphia, PA, 19107, USA. .