Therapeutic Strategies for Asymptomatic Upper Urinary Tract Urothelial Carcinoma

Abstract A total of 136 patients with upper urinary tract epithelial carcinoma (UTUC) were recruited, of which 21 patients with asymptomatic UTUC were group A, and 115 UTUC patients with hematuria or low back pain were group B. The clinicopathological features, oncologic outcomes, and surgical methods of patients were evaluated. The full-length renal ureterectomy+bladder sleeve resection was the main surgical treatment which was included (group A 80.95%, group B 90.43%). Other patients were treated with kidney-retaining surgery. No statistically significant difference was observed in the grading between groups A and B, pathological stage (p >0.05). During a median follow-up period of 44.3 months, tumor-specific mortality of group A was 7.14%, and that of group B was 5.10%. At the same period, the clinical data of 106 patients with asymptomatic bladder tumor were collected: 31 patients of them had asymptomatic bladder urothelial carcinoma. The asymptomatic UTUC group had a higher stage and grade clinicopathological features (P = 0.00), more aggressive than the asymptomatic bladder urothelial carcinoma group. The principle of asymptomatic UTUC treatment is the same as that of symptomatic UTUC. Risk stratification should be carried out according to clinical staging and other parameters, and the corresponding surgical treatment should be selected.

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Gender-related differences in clinicopathological features of patients with upper urinary tract urothelial carcinoma

European Urology Supplements ◽

10.1016/s1569-9056(18)32641-1 ◽

2018 ◽

Vol 17 (5) ◽

pp. e2235

Author(s):

K. Kaczmarek ◽

A. Lemiński ◽

D. Gajewska ◽

A. Gołąb ◽

M. Soczawa ◽

...

Keyword(s):

Urinary Tract ◽

Urothelial Carcinoma ◽

Upper Urinary Tract ◽

Clinicopathological Features ◽

Urinary Tract Urothelial Carcinoma

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Clinical staging of upper urinary tract urothelial carcinoma for T staging: Review and pictorial essay

International Journal of Urology ◽

10.1111/iju.14068 ◽

2019 ◽

Vol 26 (11) ◽

pp. 1024-1032 ◽

Cited By ~ 3

Author(s):

Yukiko Honda ◽

Yuko Nakamura ◽

Jun Teishima ◽

Keisuke Goto ◽

Toru Higaki ◽

...

Keyword(s):

Urinary Tract ◽

Urothelial Carcinoma ◽

Upper Urinary Tract ◽

Clinical Staging ◽

Pictorial Essay ◽

Urinary Tract Urothelial Carcinoma

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Clinical utility and concordance of upper urinary tract cytology and biopsy in predicting clinicopathological features of upper urinary tract urothelial carcinoma

Human Pathology ◽

10.1016/j.humpath.2018.11.021 ◽

2019 ◽

Vol 86 ◽

pp. 76-84 ◽

Cited By ~ 3

Author(s):

Caroline T. Simon ◽

Stephanie L. Skala ◽

Alon Z. Weizer ◽

Sapan N. Ambani ◽

Arul M. Chinnaiyan ◽

...

Keyword(s):

Urinary Tract ◽

Urothelial Carcinoma ◽

Clinical Utility ◽

Upper Urinary Tract ◽

Clinicopathological Features ◽

Urinary Tract Urothelial Carcinoma

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Influence of Vesicoureteral Reflux and Urinary Tract Infection on Renal Growth in Children with Upper Urinary Tract Duplication

Acta Radiologica ◽

10.1177/028418518903000412 ◽

1989 ◽

Vol 30 (4) ◽

pp. 391-394

Author(s):

L. Hannerz ◽

I. Wikstad ◽

G. Celsi ◽

A. Aperia

Keyword(s):

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Vesicoureteral Reflux ◽

Upper Urinary Tract ◽

Renal Growth ◽

Group A ◽

Group B ◽

Parenchymal Thickness ◽

Renal Length

The growth of the renal parenchyma was examined in children with duplicated outflow systems, vesicoureteral reflux (VUR), urinary tract infection (UTI) and no sign of obstruction. Ten patients with reflux occurring only in the caudal system (group A) and 4 patients with reflux both to the caudal and the apical system (group B) were studied shortly after their first UTI (study 1) and then 1.5 to 9 years later (study 2). The frequency of UTI was relatively high during the follow-up period. At urography, renal length and renal area were normal in group A in studies 1 and 2. Parenchymal thickness of the apical pole (APT/L) did not differ from normal values in any of the studies. Parenchymal thickness of the caudal pole (CPT/L) was significantly smaller than normal in both studies. There was also a significant decrease in CPT/L between study 1 and 2. UTI during the first year of life was associated with a greater reduction in CPT/L. The determination of renal length and renal area in children with a duplicated ureter, VUR and UTI, does not identify subjects at risk of developing renal growth retardation while serial determinations of parenchymal thickness appear to be an appropriate method.

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C119 EFFECT OF SURGICAL TREATMENT ON SURVIVAL WITHOUT RECURRENCE (RFS) IN PATIENTS WITH UROTHELIAL CARCINOMA OF UPPER URINARY TRACT (UCUUT)

European Urology Supplements ◽

10.1016/s1569-9056(11)61699-0 ◽

2011 ◽

Vol 10 (9) ◽

pp. 642

Author(s):

P.G. Yakovlev ◽

V.S. Sakalo ◽

V.V. Mrachkovskiy ◽

Y.Y. Kuranov

Keyword(s):

Urinary Tract ◽

Surgical Treatment ◽

Urothelial Carcinoma ◽

Upper Urinary Tract

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Primary-multiple synchronous malignant neoplasms renal pelvis and both ureters

Experimental and Сlinical Urology ◽

10.29188/2222-8543-2021-14-2-23-29 ◽

2021 ◽

Vol 14 (2) ◽

pp. 23-29

Author(s):

S.V. Popov S.V. ◽

◽

R.G. Guseynov ◽

O.N. Skryabin ◽

A.S. Peremyshlenko ◽

...

Keyword(s):

Urinary Tract ◽

Surgical Treatment ◽

Urothelial Carcinoma ◽

Bladder Wall ◽

Upper Urinary Tract ◽

Malignant Neoplasms ◽

Low Grade ◽

Left Ureter ◽

Organ Sparing ◽

The Right

Introduction. Urothelial carcinoma of the upper urinary tract in Western countries of Erope and USA occurs in 1-2 cases per 100,000 populations. Nephroretrectomy remains the main method of treatment of this pathology, however, the role of organ-sparing surgeries increases with the bilateral localization of the tumor process. Due to the rarity of bilateral upper urinary tract lesions with urothelial cancer and the lack of data evaluating the results of organ-sparing surgeries in such situations, each clinical case is of interest. Materials and methods. The article describes a case of surgical treatment of a patient with non-invasive papillary urothelial carcinomas of both ureters and the pelvis of the right kidney, which were manifested by macrohematuria. Results. The diagnosis was confirmed by computer tomography (CT) and ureteroscopy with tumor biopsy, which revealed a neoplasm of the right kidney pelvis, multiple tumors of the distal part of the right ureter and a solitary neoplasm of the middle part of left ureter. The patient underwent laparoscopic nephrureterectomy on the right with transurethral resection of the bladder wall in the area of the mouth of the right ureter and endoscopic removal of the neoplasm in the middle third of the left ureter using laser energy. At the control examination 1,5 months after the surgical treatment, according to the results of CT, cystoscopy with biopsy of the bladder and ureteroscopy, as well as histological examination of the biopsies, no data for tumor growth were found. At CT 6 months after the surgery, no data for the recurrence of cancer were obtained. Сonclusions. This clinical observation demonstrates the technical feasibility and oncological feasibility of using organ-preserving surgical treatment for bilateral localization of low-grade urothelial carcinoma.

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Higher Cancer Mortality in Rural Upper Urinary Tract Urothelial Carcinoma Patients

Urologia Internationalis ◽

10.1159/000513361 ◽

2021 ◽

pp. 1-7

Author(s):

Claudia Collà Ruvolo ◽

Lara F. Stolzenbach ◽

Luigi Nocera ◽

Marina Deuker ◽

Mike Wenzel ◽

...

Keyword(s):

Urinary Tract ◽

Surgical Treatment ◽

Urothelial Carcinoma ◽

Tumor Grade ◽

Tumor Location ◽

Upper Urinary Tract ◽

Low Grade ◽

Exact Matching ◽

T Stage ◽

Urinary Tract Urothelial Carcinoma

Objective: The aim of the study was to investigate differences in the stage at presentation and cancer-specific mortality (CSM) between rural area (RA) and urban area (UA) residence status in nonmetastatic upper urinary tract urothelial carcinoma (UTUC) patients. Methods: Newly diagnosed T1–3N0M0 UTUC patients with available residence status were abstracted from the Surveillance, Epidemiology, and End Results database (2004–2016). Propensity score (PS) matching (1 RA vs. 3 UA) accounted for age (interval ≤2 years), T stage (exact matching: T1, T2, and T3), and tumor grade (exact matching: high grade, low grade/unknown). Cumulative incidence plots and multivariable competing risk regression models focused on CSM, after adjustment for other-cause mortality. Results: Of 6,012 patients, 125 (2.1%) resided in RAs and 5,887 (97.9%) in UAs. RA patients were younger than UA patients (median age 72 vs. 75 years, p = 0.03). No differences were recorded in tumor location, T stage, tumor grade, or surgical treatment between RA and UA patients. After 1:3 PS matching, 125 RA patients and 375 UA patients were assessable. At 5 years of follow-up, CSM rates were 26.7 versus 15.7% according to RA versus UA, respectively. After additional multivariable adjustment for age, sex, tumor location, and surgical treatment, RA remained an independent predictor of higher CSM (hazard ratio 1.75, p = 0.02). Conclusions: Despite no differences in cancer characteristics, UTUC patients in RA are at higher risk of CSM than their UA counterparts. This suggests suboptimal care delivery and compliance as possible causes. Complex and/or rare disease should be centralized to expert centers, which are often in UAs.

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