Comprehensive Management of Upper Tract Urothelial Carcinoma

Urothelial carcinoma of the upper urinary tract represents only 5% of all urothelial cancers. The 5-year cancer-specific survival in the United States is roughly 75% with grade and stage being the most powerful predictors of survival. Nephroureterectomy with excision of the ipsilateral ureteral orif...

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Main Authors: Georgios Koukourakis, Georgios Zacharias, Michael Koukourakis, Kiriaki Pistevou-Gobaki, Christos Papaloukas, Athanasios Kostakopoulos, Vassilios Kouloulias
Format: Article
Language:English
Published: Wiley 2009-01-01
Series:Advances in Urology
Online Access:http://dx.doi.org/10.1155/2009/656521
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Summary:Urothelial carcinoma of the upper urinary tract represents only 5% of all urothelial cancers. The 5-year cancer-specific survival in the United States is roughly 75% with grade and stage being the most powerful predictors of survival. Nephroureterectomy with excision of the ipsilateral ureteral orifice and bladder cuff en bloc remains the gold standard treatment of the upper urinary tract urothelial cancers, while endoscopic and laparoscopic approaches are rapidly evolving as reasonable alternatives of care depending on grade and stage of disease. Several controversies remain in their management, including a selection of endoscopic versus laparoscopic approaches, management strategies on the distal ureter, the role of lymphadenectomy, and the value of chemotherapy in upper tract disease. Aims of this paper are to critically review the management of such tumors, including endoscopic management, laparoscopic nephroureterectomy and management of the distal ureter, the role of lymphadenectomy, and the emerging role of chemotherapy in their treatment.
ISSN:1687-6369
1687-6377