Management of primary upper urinary tract carcinoma in situ diagnosed by ureteroscopic biopsy: Is bacillus Calmette-Guerin an alternative to nephroureterectomy?

Territo, Angelo; Fontanet, Sofía; Gallioli, Andrea; Sanguedolce, Francesco; Rodríguez-Faba, Óscar; Gaya, J.M.; Palou, Joan; Huguet, J.; Breda, Alberto

doi:10.1016/j.acuroe.2022.11.002

Cited by 2 publications

(1 citation statement)

References 29 publications

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“…Mitomycin C (MMC) has been tested both as induction therapy and single-shot adjuvant treatment [22,23]. Similarly, upper tract instillation with Bacillus Calmette-Guerin (BCG) has been considered in patients diagnosed with CIS using a similar schedule of instillations to that used in bladder cancer [24 ▪ ]. However, although the evidence is low, there is still uncertainty regarding the efficacy of endocavitary instillations in UTUC [1].…”

Section: Technologies To Improve the Efficacy Of Endoscopic Treatment...mentioning

confidence: 99%

New technologies for nephron-sparing surgery in upper urinary tract cancers

Gallioli,

Basile,

Territo

et al. 2023

Current Opinion in Urology

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Purpose of review Nephron-sparing surgery (NSS) is the preferred treatment in patients with low-risk upper tract urothelial carcinoma (UTUC). Improving both instruments and topical chemotherapy regimens efficacy is crucial to achieve better outcomes. The purpose of this review is to summarize the most recent evidence on technological advances for the conservative management of UTUC with implications on diagnosis and treatment. Recent findings Novel diagnostic tools, lasers, and topical chemotherapy systems delivery have been implemented to optimize NSS outcomes for UTUC. Summary Photodynamic ureteroscopy has been reported to improve cancer detection rate as compared with conventional imaging or ureteroscopy, especially in case of carcinoma in situ. However, refinements in photosensitizer administration and dedicated instruments are needed. The armamentarium of lasers for UTUC ablation is composed of several devices with peculiar characteristics. Together with Ho:YAG and Tm:YAG lasers, the Thulium Fiber Laser (TFL) is gaining momentum in UTUC ablation. Strengths and weaknesses of each laser must be considered to maximize oncological and safety outcomes. Several novel endocavitary chemotherapy delivery systems have been tested to reduce tumor recurrence and progression after NSS. Administration of gel-based chemotherapeutic agents has been proven to be effective in humans; conversely, drug-eluting ureteral stent systems are still conceptual.

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Section: Technologies To Improve the Efficacy Of Endoscopic Treatment...mentioning

confidence: 99%