Skip to main content
SpringerLink
Log in

Diagnosis and Surveillance of Upper Tract Tumors

  • Chapter
Book cover Advanced Endourology

Part of the book series: Current Clinical Urology ((CCU))

  • 755 Accesses

Abstract

Upper tract transitional cell carcinoma is rare and historically has resulted in nephroureterectomy. Diagnosis and treatment historically relied upon finding radiographic filling defects in the collecting system. With the advent of small caliber ureteroscopes, small working instruments, and lasers, nephron-sparing procedures are available to these patients. Additionally, these technological advances can be used to rapidly diagnose patients.

The results of endoscopic treatment in transitional cell carcinoma are based on the fact that survival is directly related to the grade and stage of the tumor. Low grade lesions recur less frequently and have less invasive potential than high grade lesions. After endoscopic treatment of upper tract transitional cell carcinoma, low grade lesions rarely progress and recurrences usually respond to retreatment. This chapter describes the background surrounding upper tract transitional cell carcinoma. It also outlines the diagnosis and surveillance regimens and report treatment results.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Cummings KB. Nephroureterectomy: rationale in the management of transitional cell carcinoma of the upper urinary tract. Urol Clin North Am 1980; 7(3): 569–578.

    PubMed  CAS  Google Scholar 

  2. Charbit L, Gendreau MC, Mee S, Cukier J. Tumors of the upper urinary tract: 10 years of experience. J Urol 1991; 146: 1243–1246.

    PubMed  CAS  Google Scholar 

  3. Babaian RJ, Johnson DE. Primary carcinoma of the ureter. J Urol 1980; 123(3): 357–359.

    PubMed  CAS  Google Scholar 

  4. Zungri E, Chechile G, Algaba F, Diaz I, Vila F, Castro C. Treatment of transitional carcinoma of the ureter: Is controversy justified? Eur Urol 1990; 17: 276–280.

    PubMed  CAS  Google Scholar 

  5. Zincke H, Neves RJ. Feasibility of conservative surgery for transitional cell cancer of the upper urinary tract. Urol Clin North Am 1984; 11(4): 717–724.

    PubMed  CAS  Google Scholar 

  6. Murphy DM, Zincke H, Furlow WL. Management of high grade transitional cell cancer of the upper urinary tract. J Urol 1981; 125(1): 25–29.

    PubMed  CAS  Google Scholar 

  7. Keeley FX Jr, Bibbo M, Bagley DH. Ureteroscopic treatment and surveillance of upper urinary tract transitional cell carcinoma. J Urol 1997; 157: 1560–1565.

    Article  PubMed  Google Scholar 

  8. Elliott DS, Blute ML, Patterson DE, Bergstrahl EJ, Segura JW. Long-term follow-up of endoscopically treated upper urinary tract transitional cell carcinoma. Urology 1996; 47(6): 819–825.

    Article  PubMed  CAS  Google Scholar 

  9. Chen GL, Bagley DH. Ureteroscopic management of upper tract transitional cell carcinoma in patients with normal contralateral kidneys. J Urol 2000; 164(4): 1173–1176.

    Article  PubMed  CAS  Google Scholar 

  10. Tawfiek ER, Bagley DH. Upper-tract transitional cell carcinoma. Urology 1997; 50(3): 321–329.

    Article  PubMed  CAS  Google Scholar 

  11. Jemal A, Murray T, Samuels A, Ghafoor A, Ward E, Thun M. Cancer Statistics 2003. CA Cancer J Clin 2003; 53: 5–26.

    PubMed  Google Scholar 

  12. Fraley EE, Lange PH, Hakala TR. Recent studies on the immunobiology and biology of human urothelial tumors. Urol Clin North Am 1976; 3(1): 31–51.

    PubMed  CAS  Google Scholar 

  13. Huben RP, Mounzer AM, Murphy GP. Tumor grade and stage as prognostic variables in upper tract urothelial tumors. Cancer 1988; 62(9): 2016–2020.

    Article  PubMed  CAS  Google Scholar 

  14. Gerber GS, Lyon ES. Endourological management of upper tract urothelial tumors. J Urol 1993; 150: 2–7.

    PubMed  CAS  Google Scholar 

  15. Jenson OM, Knudsen JB, Mclaughlin JK. The Copenhagen case-control study of renal pelvis and ureter cancer: role of smoking and occupational exposures. Int J Cancer 1988; 41: 557–561.

    Article  Google Scholar 

  16. Morrison AS. Advances in the etiology of urothelial cancer. Urol Clin North Am 1984; 11(4): 557–566.

    PubMed  CAS  Google Scholar 

  17. Radovanovic Z, Krajinovic S, Hall PW, Petkovic S. Family history of cancer among cases of upper urothelial tumors in Balkan nephropathy area. J Cancer Res Clin Oncol 1985; 110: 181–183.

    Article  PubMed  CAS  Google Scholar 

  18. Grossfeld GD, Wolf JS Jr, Litwin MS, et al. Asymptomatic microscopic hematuria in adults: summary of the AUA best practice policy recommendations. Am Fam Physician 2001; 63(6): 1145–1154.

    PubMed  CAS  Google Scholar 

  19. Grossfield GD, Litwin MS, Wolf JS Jr, et al. Evaluation of asymptomatic microscopic hematuria in adults: the American urological association best practice policy-part II: patient evaluation, cytology, voided markers, imaging, cystoscopy, nephrology evaluation, and follow-up. Urology 2001; 57: 604–610.

    Article  Google Scholar 

  20. Fracchia JA, Motta J, Miller LS, Armenakas NA, Schumann GB, Greenberg RA. Evaluation of asymptomatic microhematuria. Urology 1995; 46(4): 484–489.

    Article  PubMed  CAS  Google Scholar 

  21. Jaffe JS, Ginsberg PC, Gill R, Harkaway RC. A new diagnostic algorithm for the evaluation of microscopic hematuria. Urology 2001; 57: 889–894.

    Article  PubMed  CAS  Google Scholar 

  22. Grossfeld GD, Carroll PR. Evaluation of microscopic hematuria. Urol Clin North Am 1998; 25(4): 661–676.

    Article  PubMed  CAS  Google Scholar 

  23. Jamis-Dow CA, Choyke PL, Jenninngs SB, Linehan WM, Thakore KN, Walther MM. Small (<3cm) renal masses: detection with CT versus US and pathologic correlation. Radiology 1996 (3); 198: 785–788.

    PubMed  CAS  Google Scholar 

  24. Warshauer DM, McCarthy SM, Street L, et al. Detection of renal masses: sensitivities and specificities of excretory urography/linear tomography, US, and CT. Radiology 1988; 169(2): 363–365.

    PubMed  CAS  Google Scholar 

  25. Fielding JR, Steele G, Fox LA, Heller H, Loughlin KR. Spiral computerized tomography in the evaluation of acute flank pain: a replacement for excretory urography. J Urol 1997; 157(6): 2071–2073.

    Article  PubMed  CAS  Google Scholar 

  26. Klein LT, Frager D, Subramanium A, Lowe FC. Use of magnetic resonance urography. Urology 1998; 52: 602–608.

    Article  PubMed  CAS  Google Scholar 

  27. Jung P, Brauers A, Nolte-Ernsting CA, Jakse G, Gunther RW. Magnetic resonance urography enhanced by gadolinium and diuretics: a comparison with conventional urography in diagnosing the cause of ureteric obstruction. BJU Int 2000; 86: 960–965.

    Article  PubMed  CAS  Google Scholar 

  28. Maier U, Simak R, Neuhold N, The clinical value of urinary cytology: 12 years of experience with 615 patients. J Clin Pathol 1995; 48(4): 314–317.

    Article  PubMed  CAS  Google Scholar 

  29. Kannan, V. Papillary transitional-cell carcinoma of the upper urinary tract: a cytological review. Diagn Cytopath 1990; 6(3): 204–209.

    Article  CAS  Google Scholar 

  30. Chen GL, El-Gabry EA, Bagley DH. Surveillance of upper urinary tract transitional cell carcinoma: The role of ureteroscopy, retrograde pyelography, cytology and urinalysis. J Urol 2000; 164(6): 1901–1904.

    Article  PubMed  CAS  Google Scholar 

  31. Nakada SY. The diagnosis and management of lateralizing essential hematuria. AUA Update Series 2003; 22(13): 97–104.

    Google Scholar 

  32. Keeley FX, Kulp DA, Bibbo M, McCue PA, Bagley DH. Diagnostic accuracy of ureteroscopic biopsy in upper tract transitional cell carcinoma. J Urol 1997; 157(1): 33–37.

    Article  PubMed  CAS  Google Scholar 

  33. Fleming ID, Cooper JS, Henson DE, et al. CC cancer staging manual/American joint committee on cancer.-5th Ed. Philadelphia, Lippincott-Ravens Publishers. 1997: 235–237.

    Google Scholar 

  34. Liu JB, Bagley DH, Conlin MJ, Merton DA, Alexander AA, Goldberg BB. Endoluminal sonographic evaluation of ureteral and renal pelvic neoplasms. J Ultrasound Med 1997; 16(8): 515–521.

    PubMed  CAS  Google Scholar 

  35. Guarnizo E, Pavlovich CP, Seiba M, Carlson DL, Vaughan ED Jr, Sosa RE. Ureteroscopic biopsy of upper tract urothelial carcinoma: improved diagnostic accuracy and histopathological considerations using a multi-biopsy approach. J Urol 2000; 163(1): 52–55.

    Article  PubMed  CAS  Google Scholar 

  36. Suh RS, Faerber GJ, Wolf JS. Predictive factors for applicability and success with Endoscopic treatment of upper tract urothelial carcinoma. J Urol 2003; 170: 2209–2216.

    Article  PubMed  Google Scholar 

  37. Bagley DH. Ureteroscopic laser treatment of upper urinary tract tumors. J Clin Laser Med Surg 1998; 16(1): 55–59.

    PubMed  CAS  Google Scholar 

  38. Canfield SE, Dinney CPN, Droller MJ. Surveillance and management of recurrence for upper tract transitional cell carcinoma. Urol Clin North Am 2003; 30: 791–802.

    Article  PubMed  Google Scholar 

  39. Jabour ME, Smith AD. Primary percutaneous approach to upper urinary tract transitional cell carcinoma Urol Cl North Am 2000; 27(4): 739–749.

    Article  Google Scholar 

  40. Elliott DS, Segura JW, Lightner D, Patterson DE, Blute ML. Is nephroureterectomy necessary in all cases of upper tract transitional cell carcinoma? Long-term results of conservative endourologic management of upper tract transitional cell carcinoma in individuals with a normal contralateral kidney. Urology 2001; 58(2): 174–178.

    Article  PubMed  CAS  Google Scholar 

  41. Skacel M, Fahmy M, Brainard JA, et al. Multitarget fluorescence hybridization assay detects transitional cell carcinoma in the majority of patients with bladder cancer and atypical or negative urine cytology. J Urol 2003; 169(6): 2102–2105.

    Article  CAS  Google Scholar 

  42. Sarosdy MF, Schellhammer PF, Bokinsky G, et al. Clinical evaluation of a multi-target fluorescent in situ hybridization assay for detection of bladder cancer. J Urol 2002; 168(5): 1950–1954.

    Article  PubMed  CAS  Google Scholar 

  43. Jones JS, Streem SB. Office-based cystoureteroscopy for assessment of the upper urinary tract J Endourol 2002; 16(5): 307–309.

    Article  PubMed  Google Scholar 

  44. Kerbl K, Clayman RV. Incision of the ureterovesical junction for endoscopic surveillance of transitional cell cancer of the upper urinary tract. J Urol 1993; 150: 1440–1443.

    PubMed  CAS  Google Scholar 

  45. Corwin HL, Silverstein MD. The diagnosis of neoplasia in patients with asymptomatic microscopic hematuria: a decision analysis. J Urol 1988; 139(5): 1002–1006.

    PubMed  CAS  Google Scholar 

  46. Fielding JR, Silverman SG, Samuel S, Zou KH, Loughlin KR. Unenhanced helical CT of ureteral stones: a replacement for excretory urography in planning treatment. AJR Am J Roentgenol 1998; 171: 1051–1053.

    PubMed  CAS  Google Scholar 

  47. McNicholas MM, Raptopoulos VD, Schwartz RK, et al. Excretory phase CT urography for opacification of the urinary collecting system. AJR Am J Roentgenol 1998; 170: 1261–1267.

    PubMed  CAS  Google Scholar 

  48. Badalament RA, Bennett WF, Bova JG, et al. Computed tomography of primary transitional cell carcinoma of the upper urinary tracts. Urology 1992; 40(1): 71–75.

    Article  PubMed  CAS  Google Scholar 

  49. Badalament RA, Hermansen DK, Kimmel M, et al. The sensitivity of bladder wash flow cytometry, bladder wash cytology and voided cytology in the detection of bladder carcinoma. Cancer 1987; 60: 1423–1427.

    Article  PubMed  CAS  Google Scholar 

  50. Xia TL. Cytologic diagnostic value of voided urine in 60 cases of primary transitional carcinoma of the renal pelvis and ureter. Chung Hua Wai Ko Tsa Chih 1989; 27(12): 753–755.

    PubMed  CAS  Google Scholar 

  51. Daneshmand S, Quek ML, Huffman JL. Endoscopic management of upper urinary tract transitional cell carcinoma: Long-term experience. Cancer 2003; 98(1): 55–60.

    Article  PubMed  Google Scholar 

  52. Nielsen K, Ostri P. Primary tumors of the renal pelvis: evaluation of clinical and pathological features in a consecutive series of 10 years. J Urol 1988; 140(1): 19–21.

    PubMed  CAS  Google Scholar 

  53. Ozsahin M, Zourhair A, Villa S, et al. Prognostic factors in urothelial renal pelvis and ureter tumours: a multicentre rare cancer network study. Eur J Cancer 1999; 35(5): 738–743.

    Article  PubMed  CAS  Google Scholar 

  54. Skolarikos A, Griffiths TRL, Powell PH, Thomas DJ, Neal DE, Kelly JD. Cytologic analysis of ureteral washings is informative in patients with grade 2 upper tract TCC considering Endoscopic treatment. Urology 2003; 61(6): 1146–1150.

    Article  PubMed  CAS  Google Scholar 

  55. Assimos DG, Hall MC, Martin JH. Ureteroscopic management of patients with upper tract transitional cell carcinoma. Urol Cl North Am 2000; 27(4): 751–759.

    Article  CAS  Google Scholar 

  56. Martinez-Pineiro JA, Matres MJG, Martinez-Pineiro L. Endourological treatment of upper tract urothelial carcinomas: analysis of a series of 59 tumors. J Urol 1996; 156: 377–385.

    Article  PubMed  CAS  Google Scholar 

  57. Liatsikos EN, Dinlenc CZ, Kapoor R, Smith AD. Transitional-cell carcinoma of the renal pelvis: ureteroscopic and percutaneous approach. J Endourol 2001; 15(4): 377–383.

    Article  PubMed  CAS  Google Scholar 

  58. Clark PE, Streem SB, Geisinger MA. 13-year experience with percutaneous management of upper tract transitional cell carcinoma. J Urol 1999; 161(3): 772–775.

    Article  PubMed  CAS  Google Scholar 

  59. Patel A, Soonawalla P, Shepherd SF, Dearnaley DP, Kellett MJ, Woodhous CRJ. Long-term outcome after percutaneous treatment of transitional cell carcinoma of the renal pelvis. J Urol 1996; 155(3): 868–874.

    Article  PubMed  CAS  Google Scholar 

  60. Jarrett TW, Sweetser PM, Weiss GH, Smith AD. Percutaneous management of transitional cell carcinoma of the renal collecting system: 9-year experience. J Urol 1995; 154(5): 1629–1635.

    Article  PubMed  CAS  Google Scholar 

  61. Tomera KM, Leary FJ, and Zinke H. Pyeloscopy in urothelial tumors. J Urol 1982; 127: 1088–1089.

    PubMed  CAS  Google Scholar 

  62. Lim DJ, Shattuck MC, Cook WA. Pyelovenous lymphatic migration of transitional cell carcinoma following ureterorenoscopy. J Urol 1993; 149(1): 109–111.

    PubMed  CAS  Google Scholar 

  63. Kulp DA, Bagley DH. Does flexible ureteropyeloscopy promote local recurrence of transitional cell carcinoma? J Endourol 1994; 8(2): 111–113.

    Article  PubMed  CAS  Google Scholar 

  64. Hendin BN, Streem SB, Levin HS, Klein EA, Novick AC. Impact of diagnostic ureteroscopy on longterm survival in patients with upper tract transitional cell carcinoma. J Urol 1999; 161(3): 783–785.

    Article  PubMed  CAS  Google Scholar 

  65. Chen GL, Bagley DH. Ureteroscopic surgery for upper tract transitional-cell carcinoma: complications and management. J Endourol 2001; 15(4): 399–404.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Eastern Virginia Medical School, Norfolk, VA

    Douglas W. Soderdahl MD & Michael D. Fabrizio MD, FACS

Authors
  1. Douglas W. Soderdahl MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael D. Fabrizio MD, FACS
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. The University of Wisconsin Medical School, Madison, WI

    Stephen Y. Nakada MD

  2. The University of Texas Southwestern Medical Center, Dallas, TX

    Margaret S. Pearle MD, PhD

Rights and permissions

Reprints and permissions

Copyright information

© 2006 Humana Press Inc., Totowa, NJ

About this chapter

Cite this chapter

Soderdahl, D.W., Fabrizio, M.D. (2006). Diagnosis and Surveillance of Upper Tract Tumors. In: Nakada, S.Y., Pearle, M.S. (eds) Advanced Endourology. Current Clinical Urology. Humana Press. https://doi.org/10.1007/978-1-59259-954-7_5

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-954-7_5

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-446-3

  • Online ISBN: 978-1-59259-954-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation