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Management of Upper Tract Urothelial Carcinoma

  • Genitourinary Cancers (DP Petrylak and JW Kim, Section Editors)
  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

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.

Summary

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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Fig. 1
Fig. 2

Adapted from the EAU guidelines on upper tract urothelial carcinoma 2020

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Authors and Affiliations

  1. Department of Urology, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Thomas Jefferson University, 1025 Walnut Street, Suite 1100, Philadelphia, PA, 19107, USA

    Asaf Shvero & Scott G. Hubosky

  2. Department of Urology, Sheba Medical Center, Ramat-Gan, Israel

    Asaf Shvero

  3. Tel Aviv University, Tel Aviv, Israel

    Asaf Shvero

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Correspondence to Scott G. Hubosky.

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Asaf Shvero declares that he has no conflict of interest. Scott G. Hubosky has received compensation for service as a consultant from Boston Scientific Corporation, and his institution (Sidney Kimmel Medical College at Thomas Jefferson University Hospital) participated in the OLYMPUS trial of UroGen’s UGN-101 (Jelmyto™), completely under local institutional review board approval.

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Shvero, A., Hubosky, S.G. Management of Upper Tract Urothelial Carcinoma. Curr Oncol Rep 24, 611–619 (2022). https://doi.org/10.1007/s11912-021-01179-8

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