Role of Ureteroscopy in Treatment of Upper Tract Urothelial Carcinoma

Hin, Jeremy Ng Chieng; Hettiarachchilage, Dinul; Gravestock, Paul; Rai, Bhavan; Somani, Bhaskar; Veeratterapillay, Rajan

doi:10.1007/s11934-021-01065-7

Cited by 10 publications

(8 citation statements)

References 59 publications

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“…Ng Chieng et al reported a high local recurrence rate of 46% at a mean follow-up time of 4.9 months after endoscopic treatment. 10 The risk of intravesical recurrence after treatment of UTUC is relatively high (30-40%), whereas the recurrence rate in the contralateral upper urinary tract, as observed in our two cases, is rare (2-6%). 11 Moreover, there are still some issues to be discussed.…”

Section: Discussionmentioning

confidence: 46%

Endoscopic Ablation of Upper Tract Urothelial Carcinoma: A Report of Two Cases with Long Disease Recurrence-Free Periods

et al. 2022

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Upper tract urothelial carcinoma (UTUC) is a relatively rare disease that accounts for 5% to 10% of all urothelial carcinomas (UCs). Radical nephroureterectomy (RNU) with a bladder cuff is the current gold standard for the management of UTUC; however, endoscopic ablation is also an option for low-risk UTUC to preserve kidney function. Herein, we present two cases of solitary kidney with a right lower ureteral tumor. Both patients underwent left RNU in the past. An 82-year-old man with a right ureteral tumor whose histopathological examination revealed low-grade UC. Laser ablation was performed with ureteroscopy, and there was no recurrence for 7 years after treatment. A 67-year-old woman with a right lower ureteral tumor whose histopathological examination also revealed low-grade UC. Laser ablation was performed, and there was no recurrence for 5 years after the treatment. We closely followed-up our two patients after RNU. This allowed for early detection of tumor recurrence, after which we could perform laser ablation therapy.

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Section: Discussionmentioning

confidence: 46%

Endoscopic Ablation of Upper Tract Urothelial Carcinoma: A Report of Two Cases with Long Disease Recurrence-Free Periods

et al. 2022

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“…This needs to be prospectively evaluated in larger randomized studies. 23,24 The present study had a few limitations. Firstly, there are inevitable biases due to its retrospective design, and patients receiving non-protocol-based URS biopsy procedures including variations in the quality of tissue samples obtained.…”

Section: Discussionmentioning

confidence: 89%

Urinary bladder recurrences following ureteroscopic biopsies of upper tract urothelial cancers: a multi-centre observational study with genomic assessment for clonality

et al. 2022

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Background and aims Urinary bladder recurrences (UBRs) after radical nephroureterectomy (RNUx) are a known challenge in patients with upper-tract urothelial cancers (UTUCs). We aim to assess factors associated with UBR and clonal-relatedness with resected UTUC. Methods Patients who underwent RNUx for UTUC between 1998 and 2015 in five institutions were identified. Clonal relatedness between primary UTUC and subsequent UBR in a sub-cohort was assessed using next-generation sequencing. A Kaplan–Meier curve was used to assess differences in UBR between two groups (with or without ureteroscopic biopsy). Results Of 267 patients with complete records, 73 (27.3%) had UBR during follow-up. The five-year UBR-free survival in all patients was 64.7%. The five-year UBR-free-survival was inferior in patients who underwent URS biopsy compared with patients who did not undergo ureteroscopic biopsy (49.9% vs 76.4%, p < 0.001). History of bladder tumour (HR, 95% CI; 2.94, 1.73–5.00, p < 0.001), ureteroscopic biopsy (HR, 95% CI; 2.21, 1.38–3.53, p = 0.001) and preoperative urine cytology ≥C3 (HR, 95% CI; 2.06, 1.24–3.40, p = 0.005) were independently associated with UBR. Patients with ureteroscopic biopsy (n = 3/5) showed identical mutational changes for common genes ( TP53 and FGFR3) between primary UTUC and subsequent UBR. Conclusions Ureteroscopic biopsy of UTUC is a significant risk factor for UBR. Qualitative clonality assessment showed identical mutational signatures between primary UTUC and UBR.

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“…Upper tract urothelial carcinoma (UTUC) accounts for up to 10% of all urothelial neoplasms [1]. On the basis of the current European Association of Urology (EAU) guidelines, UTUCs can be divided into two groups for clinical decision making: low-risk and high-risk [2].…”

Section: Introductionmentioning

confidence: 99%

Current methods facilitating diagnosis of upper tract urothelial carcinoma: a comprehensive literature review

Krajewski

Łaszkiewicz²,

Nowak³

et al. 2023

Current Opinion in Urology

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Purpose of reviewCurrently, kidney-sparing surgeries are considered the preferred approach in low-risk tumours and in selected high-risk patients. Therefore, accurate diagnosis of UTUC is crucial for further management. The purpose of this review is to summarize available methods facilitating the diagnosis of upper tract urothelial carcinoma (UTUC). Recent findingsRecent articles propose numerous techniques of UTUC diagnosis. In this review, imaging, as well as, urinebased and endoscopic methods have been described and assessed. SummaryRegarding imaging, computed tomography urography remains a gold standard, while PET is superior in search for small lesions and nodal metastases. However, contrast-enhanced ultrasonography also shows promise. On the contrary, available urine tests, such as urinary cytology, fluorescent in-situ hybridization, Xpert, DNA methylation analysis, urine-based liquid biopsy, p16/Ki-67 dual immunolabelling, ImmunoCyt and NMP22 are either poorly researched, or not accurate enough to use solely. Finally, during ureterorenoscopy, photodynamic diagnosis and narrow-band imaging can facilitate proper visualization of the tumor. Endoluminal ultrasonography and confocal laser endomicroscopy can potentially improve staging and grading of UTUC. Also, the form tackle biopsy should be performed using a basket in papillary lesions and cold-cup biopsy of flat or sessile lesions. Even though cryobiopsy shows promise in UTUC diagnosis, in-vivo studies are necessary before it is introduced into clinical practice.

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Role of Ureteroscopy in Treatment of Upper Tract Urothelial Carcinoma

Cited by 10 publications

References 59 publications

Endoscopic Ablation of Upper Tract Urothelial Carcinoma: A Report of Two Cases with Long Disease Recurrence-Free Periods

Endoscopic Ablation of Upper Tract Urothelial Carcinoma: A Report of Two Cases with Long Disease Recurrence-Free Periods

Urinary bladder recurrences following ureteroscopic biopsies of upper tract urothelial cancers: a multi-centre observational study with genomic assessment for clonality

Current methods facilitating diagnosis of upper tract urothelial carcinoma: a comprehensive literature review

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