Antegrade Perfusion With Bacillus Calmette-Guérin in Patients With Non–Muscle-Invasive Urothelial Carcinoma of the Upper Urinary Tract: Who May Benefit?

Giannarini, Gianluca; Kessler, Thomas M.; Birkhäuser, Frédéric D.; Thalmann, George N.; Studer, Urs E.

doi:10.1016/j.eururo.2011.07.051

Cited by 117 publications

(74 citation statements)

References 17 publications

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“…Researchers have therefore extended this experience over to UTUC patients, using antegrade instillation of either agent into the upper urinary tract by percutaneous nephrostomy [61], or retrograde instillation through a ureteric stent or with the help of vesicoureteral reflux created by a double-pigtail catheter [62]. This may be useful particularly in those not eligible for surgery, with favorable medium term results similar to those observed in the bladder cancer experience [61]. Studies have also found that BCG therapy may prevent patients from requiring dialysis and provide cure for those with carcinoma in situ of the upper urinary tract [63].…”

Section: Intraluminal Therapymentioning

confidence: 99%

A contemporary review of management and prognostic factors of upper tract urothelial carcinoma

Leow

Orsola

Chang

et al. 2015

Cancer Treatment Reviews

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Section: Intraluminal Therapymentioning

confidence: 99%

A contemporary review of management and prognostic factors of upper tract urothelial carcinoma

Leow

Orsola

Chang

et al. 2015

Cancer Treatment Reviews

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“…1 Drawing on the bladder cancer literature, topical chemotherapy has been administered after endoscopic treatment of upper tract urothelial carcinoma (UUC). [2][3][4][5][6][7] Dwell time of topical chemotherapy in the upper tract, however, is poor, and recurrence rates remain high, ranging from 29% to 54%.…”

Section: Introductionmentioning

confidence: 99%

Third Place: Increasing Dwell Time of Mitomycin C in the Upper Tract with a Reverse Thermosensitive Polymer

Wang

Goldsmith²,

Neisius³

et al. 2013

Journal of Endourology

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Background and Purpose: Topical chemotherapy for urothelial cancer is dependent on adequate contact time of the chemotherapeutic agent with the urothelium. To date, there has not been a reliable method of maintaining this contact for renal or ureteral urothelial carcinoma. We evaluated the safety and feasibility of using a reverse thermosensitive polymer to improve dwell times of mitomycin C (MMC) in the upper tract. Materials and Methods: Using a porcine model, four animals were treated ureteroscopically with both upper urinary tracts receiving MMC mixed with iodinated contrast. One additional animal received MMC percutaneously. The treatment side had ureteral outflow blocked with a reverse thermosensitive polymer plug. MMC dwell time was monitored fluoroscopically and intrarenal pressures measured. Two animals were euthanized immediately, and three animals were euthanized 5 days afterward. Results: In control kidneys, drainage occurred at a mean of 5.3 -0.58 minutes. Intrarenal pressures stayed fairly stable: 9.7 -14.0 cm H 2 0. In treatment kidneys, dwell time was extended to 60 minutes, when the polymer was washed out. Intrarenal pressures in the treatment kidneys peaked at 75.0 -14.7 cm H 2 0 and reached steady state at 60 cm H 2 0. Pressures normalized after washout of the polymer with cool saline. Average washout time was 11.8 -9.6 minutes. No histopathologic differences were seen between the control and treatment kidneys, or with immediate compared with delayed euthanasia. Conclusions: A reverse thermosensitive polymer can retain MMC in the upper urinary tract and appears to be safe from our examination of intrarenal pressures and histopathology. This technique may improve the efficacy of topical chemotherapy in the management of upper tract urothelial carcinoma.

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“…Previously, several adjuvant topical agents, including Bacillus Calmette-Guérin (BCG), mitomycin C, epirubicin and thiotepa, have been used for UTUC perfusion treatment (4,8). Benefits of the antegrade perfusion with BCG in patients with UTUC following ablation of early stage tumors has also been demonstrated (8).…”

mentioning

confidence: 99%

“…Benefits of the antegrade perfusion with BCG in patients with UTUC following ablation of early stage tumors has also been demonstrated (8). Nonetheless, certain controversy remains regarding the safety and efficacy of retrograde instillations, which may cause pyelovenous influx and ureteric obstruction during perfusion (4).…”

mentioning

confidence: 99%

Nephron sparing endoscopic treatment for primary carcinoma of the renal calyx: A case report and literature review

Wang

et al. 2016

Molecular and Clinical Oncology

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Abstract. Primary carcinoma of the renal calyx is extremely rare. The present study reported nephron sparing endoscopic treatment for primary carcinoma of the renal calyx. An 81-year-old female presented with a 1-year history of intermittent painless gross hematuria. Computed tomography and X-ray of the urinary tract were unable to definitively identify any lesion. Flexible ureteroscopic examination revealed a tumor with epicenter in the lower calyx of the right kidney, with additional involvement around the calyx. Biopsies were obtained and pathology revealed low-grade urothelial carcinoma. Considering additional co-morbidities, the patient elected to undergo endoscopic management with thulium laser. The present report described the feasibility of flexible ureteroscopic thulium laser resection for the treatment of renal calyx carcinoma.

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Antegrade Perfusion With Bacillus Calmette-Guérin in Patients With Non–Muscle-Invasive Urothelial Carcinoma of the Upper Urinary Tract: Who May Benefit?

Cited by 117 publications

References 17 publications

A contemporary review of management and prognostic factors of upper tract urothelial carcinoma

A contemporary review of management and prognostic factors of upper tract urothelial carcinoma

Third Place: Increasing Dwell Time of Mitomycin C in the Upper Tract with a Reverse Thermosensitive Polymer

Nephron sparing endoscopic treatment for primary carcinoma of the renal calyx: A case report and literature review

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