Upper urinary tract urothelial carcinomas – our experience
Authors:
R. Adwan
Authors‘ workplace:
Urologické oddělení, Oblastní nemocnice Náchod
Published in:
Rozhl. Chir., 2020, roč. 99, č. 5, s. 219-225.
Category:
Original articles
doi:
https://doi.org/10.33699/PIS.2020.99.5.219–225
Overview
Introduction: Urothelial carcinoma is the second most common urological malignancy. Around 5–10% of tumors are found in the upper urinary tract, while almost 90–95% are in the bladder.
Methods: Patients of our department diagnosed with upper urinary tract urothelial carcinoma (UTUC) during the period 2014–2018 were included. The frequency, selected therapeutic procedures and treatment results were analyzed.
Results: In the last 5 years, 21 patients with UTUC were diagnosed and surgically treated at the Department of Urology, Regional Hospital Nachod. The main surgical approach was nephroureterectomy. Mortality was 28.6% due to the original tumor diagnosis. Urothelial carcinoma of the upper urinary tract was more common in men than in women in our patient group.
Conclusion: Unfortunately, urothelial carcinomas of the upper urinary tract are often dealt with only in locally advanced stages or when nodal or distant metastases are present, making any possible administration of adjuvant chemotherapy complicated as it fails to provide a sufficient effect. Therefore, radical nephroureterectomy remains the gold standard for more than a half of patients. Overall survival depends largely on the presence of distant metastases. The pT category is the major influencing parameter for a relapse.
Keywords:
urothelial carcinoma – upper urinary tract – nephroureterectomy – segmental ureterectomy
Sources
- Soukup V. Uroteliální karcinom močovodu. In: Hanuš T, Novák K, et al. Nemoci močovodu. Praha, Galén 2008:129−138.
- Colin, P, Koenig, P, Ouzzane A, et al. Environmental factors involved in carcinogenesis of urothelial cell carcinomas of the upper urinary tract. BJU Int. 2009;104(10):1436−1440. doi:10.1111/j.1464-410X.2009.08838.x.
- Macek P, Soukup V, Hanuš T, et al. Zhodnocení charakteru a vývoje onemocnění u nemocných s uroteliálními nádory horních močových cest. Endoskopie 2011;20(3−4):89.
- Prošvic P. Nádory horních močových cest: epidemiologie, etiologie a genetika. In: Dvořáček, J, Babjuk, M, et al. Onkourologie. Praha, Galén 2005:70−75.
- Köhler O, Belej K. Léčba uroteliálního karcinomu horních močových cest. Urol praxi 2012;13(5):204−207.
- Fritz GA, Schoellnast H, Deutschmann HA, et al. Multiphasic multidetector-row CT (MDCT) in detection and staging of transitional cell carcinomas of the upper urinary tract. Eur Radiol. 2006;16(6):1244−1252. doi:10.1007/s00330-005-0078-0.
- Petkovic SD. Epidemiology and treatment of renal pelvic and ureteral tumors. J Urol. 1975;114(6):858−865. doi:10.1016/s0022-5347(17)67160-x.
- Louda M, Hafuda A, Morávek P, et al. Koincidence uroteliálního karcinomu horních močových cest a močového měchýře. Ces Urol. 2003;7(1):8−10.
- Huben RP, Mounzer AM, Murphy GP. Tumour grade and stage as prognostic variables in upper urinary tract tumours. Cancer 1988;62(9):2016−2020. doi:10.1002/1097-0142(19881101) 62:9<2016:aid-cncr2820620924> 3.0.co;2-g.
- Kakizoe T, Fujita J, Murase M, et al. Transitional cell carcinoma of the bladder in patients with renal pelvic and ureteral cancer. J Urol. 1980;124(1):17−19. doi:10.1016/s0022-5347(17)55269-6.
- Oldbring J, Glifberg I, Mikulowsky PM, et al. Carcinoma of the renal pelvis and ureter following bladder carcinoma: frequency, risk factors and clinicopathological findings. J Urol. 1989;141(6):1311−1313. doi:10.1016/s0022-5347(17)41291-2.
- Hurle R, Losa A, Manzetti A, et al. Upper urinary tract tumors developing after treatment of superficial bladder cancer: 7-year follow-up of 591 consecutive patients. Urology 1999;53(6):1144−1148. doi:10.1016/s0090-4295(99)00002-3.
- Bagley DH, Healy KA, Kleinmann N, et al. Ureteroskopická biopsie tumorů horních cest močových: endoskopické a cytologické techniky. Urol List. 2012;10(2):26−30.
- Xylinas E, Klatte T, Matin S, et al. Prognostické faktory, molekulární markery a prediktivní instrumenty pro hodnocení uroteliálního karcinomu horních cest močových. Urol List. 2013;11(3):30−39.
- Liao RS, Gupta M, Schwen ZR, et al. Comparison of pathological stage in patients treated with and without neoadjuvant chemotherapy for high risk upper tract urothelial carcinoma. J Urol. 2018;200(1):68−73. doi:10.1016/j.juro.2017.12.054.
- Liu F, Guo W, Zhou X, et al. Laparoscopic versus open nephroureterectomy for upper urinary tract urothelial carcinoma: a systematic review and meta-analysis. Medicine (Baltimore) 2018;97(35):e11954. doi:10.1097/MD.0000000000011954.
- Samson P, Smith AD, Hoenig D, et al. Endoscopic management of upper urinary tract urothelial carcinoma. Journal of Endourology 2018;32(S1):S10−S16. doi: 10.1089/end.2018.0036.
- Zatloukalová P, Pjechová M, Babčanová S, et al. Úloha PD-1/PD-L1 signalizace v protinádorové imunitní odpovědi. Klin Onkol. 2016;29(suppl. 4):72−77.
- Kawaciuk I. Urologie. Praha, Galén 2009.
- Rouprêt M, Zigeuner R, Palou J, et al. European guidelines for the diagnosis and management of upper urinary tract urothelial cell carcinomas: 2011 update. Eur Urol. 2011;59(4):584–594. doi:10.1016/j.eururo.2010.12.042.
- Stefanovic V, Radovanovic Z. Balkan endemic nephropathy and associated urothelial cancer. Nat Clin Pract Urol. 2008;5(2):105−112. doi: 10.1038/ncpuro1019.
- Sostarić B, Vukelić M. Characteristics of urinary tract tumours in the area of Balkan endemicnephropathy in Croatia. IARC Sci Publ. 1991;(115):29−35.
- Yang MH, Chen KK, Yen CC, et al. Unusually high incidence of upper urinary tract urothelial carcinoma in Taiwan. Urology 2002;59(5):681−687. doi:10.1016/s0090-4295(02)01529-7.
- Rouprêt M, Yates DR, Comperat E, et al. Upper urinary tract urothelial cell carcinomas and other urological malignancies involved in the hereditary nonpolyposis colorectal cancer (Lynch syndrome) tumor spectrum. Eur Urol. 2008;54(6):1226−1236. doi: 10.1016/j.eururo.2008.08.008.
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