Open Access

REVIEW

Endoscopic management of upper tract urothelial carcinoma

Anthony J. Polcari, Cory M. Hugen, Thomas M. Turk

Department of Urology, Loyola University Stritch School of Medicine, Maywood, Illinois, USA
Address correspondence to Dr. Anthony J. Polcari, Department of Urology, Loyola University Medical Center, Fahey Center, Room 200, Maywood, IL 60153 USA

Canadian Journal of Urology 2009, 16(6), 4887-4894.

Abstract

While radical nephroureterectomy remains the gold standard of treatment for patients with upper tract urothelial tumors, technological advances have made endoscopic management possible. The careful selection of patients for such an approach is dependent upon an accurate diagnosis and an understanding of the natural history of the disease. High grade tumors behave aggressively and warrant radical extirpation unless an absolute contraindication exists. Motivated patients with low grade tumors and relative contraindications to nephroureterectomy can be managed with percutaneous or retrograde ureteroscopic techniques. High recurrence rates in the ipsilateral upper tract and bladder mandate close surveillance of patients treated conservatively. We review the important diagnostic, staging, technical, and surveillance issues in the endoscopic treatment of upper tract urothelial carcinoma.

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Keywords

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