Endourologic Management of Upper Tract Transitional Cell Carcinoma following Cystectomy and Urinary Diversion

Tomaszewski, Jeffrey J.; Smaldone, Marc C.; Ost, Michael C.

doi:10.1155/2009/976401

Cited by 8 publications

(3 citation statements)

References 51 publications

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“…Conservative endoscopic management via retrograde or percutaneous antegrade approaches as well as nephron-sparing surgery are now feasible alternatives, even in patients with normal contralateral kidneys. 22 Accurate staging by combining cross-sectional imaging techniques and endoscopic evaluation with biopsy is key to selecting the most appropriate treatment option. 7 According to the European Association of Urology (EAU) guidelines on UTUC, the indications for endourological management include unifocal low-grade tumour, which is less than 1 cm with no evidence of infiltration on CTU.…”

Section: Disease Managementmentioning

confidence: 99%

A review of the contemporary management of upper urinary tract urothelial carcinoma

Reekhaye

Sriprasad

Madaan

2017

Journal of Clinical Urology

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Upper tract urothelial carcinoma (UTUC) is relatively rare and accounts for approximately 5% of all urothelial carcinomas. The estimated annual incidence of UTUC in Western countries is about two new cases per 100,000 inhabitants. The management of patients with upper tract urothelial carcinomas has changed significantly over the last decade with improved diagnostic techniques and treatment options. The gold-standard treatment used to be open radical nephroureterectomy with removal of the ipsilateral bladder cuff. The use of minimally invasive techniques for the diagnosis and management of upper urinary tract urothelial carcinoma is however expanding and has led to a paradigm shift in treatment strategies of upper tract urothelial carcinomas. In this article, we review the current diagnostic modalities and various endoscopic techniques being currently used in the management of this relatively rare tumour.

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Section: Disease Managementmentioning

confidence: 99%

A review of the contemporary management of upper urinary tract urothelial carcinoma

Reekhaye

Sriprasad

Madaan

2017

Journal of Clinical Urology

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“…[ 12 ] A further indication of antegrade treatment is in patients with previous urinary diversion, most commonly prior cystectomy for bladder TCC, though retrograde access may be possible but often technically challenging. [ 14 15 ] A combined retrograde and antegrade approach may be necessary in patients with multifocal upper tract TCC or a renal pelvic tumor with superficial extension down the ureter. [ 16 ]…”

Section: Endoscopic Managementmentioning

confidence: 99%

Endoscopic management of upper tract transitional cell carcinoma

et al. 2010

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Upper urinary tract transitional cell carcinoma (TCC) accounts for up to 10% of cases of neoplasm of the upper urinary tract. The “gold standard” management of upper tract TCC is nephroureterectomy. Technological innovations, miniaturisations and increased availability of energy sources such as Holmium laser fibers have improved the armamentarium of endoscopic management of upper tract TCC. Endoscopic management of upper tract TCC includes the percutaneous (antegrade) and retrograde approaches. Modern flexible ureterorenoscopy allows retrograde approach to small (<1.5cm), low grade and noninvasive tumors, which is inaccessible to standard rigid ureteroscopes without breaching the urothelial barrier. In patients with large tumors or in whom retrograde access is difficult, the percutaneous approach to the renal pelvis, although more invasive, provides an alternative access and control. Both retrograde and percutaneous approaches allow instillation of various chemotherapeutic agents. Careful selection of patients is the key point in the successful endoscopic management of upper tract TCC. Patient selection is based on tumor size, grade and multifocality and other patient factors such as comorbidities, single kidney, post kidney transplant and patient choice. Both motivation and compliance of patients are needed for long-term successes. However, until large randomized trials with long term follow-up are available, endoscopic management of upper tract TCC should be reserved for only selected group of patients. This review summarizes the current techniques, indications, contraindications and outcomes of endoscopic management of UTTCC and the key published data.

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“…Furthermore, retrospective series have suggested that metastasis-directed treatment (MDT) could improve cancer-specific and overall survival with a low toxicity profile [14,15]. In particular, stereotactic body radiotherapy (SBRT) has been described as safe and feasible, allowing the postponement of systemic treatment [16][17][18][19]. Moreover, Steuber et al, reported that combination of SBRT and ADT in OPC patients might improve local control and might decrease the risk of distant failure [20].…”

Section: Introductionmentioning

confidence: 99%

Oligometastatic Prostate Cancer: A Comparison between Multimodality Treatment vs. Androgen Deprivation Therapy Alone

Mistretta

Luzzago

Conti

et al. 2022

Cancers

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Background: We compared multimodality treatment (MMT, defined as robot-assisted radical prostatectomy (RARP) with androgen deprivation therapy (ADT), with or without adjuvant radiotherapy (RT)) vs. ADT alone in oligometastatic prostate cancer (OPC) patients. Methods: From 2010 to 2018, we identified 74 patients affected by cM1a-b OPC (≤5 metastases). Kaplan–Meier (KM) plots depicted cancer-specific mortality (CSM), disease progression, metastatic castration-resistant PC (mCRPC), and time to second-line systemic therapy rates. Multivariable Cox regression models (MCRMs) focused on disease progression and mCRPC. Results: Forty (54.0%) MMT and thirty-four (46.0%) ADT patients were identified. On KM plots, higher CSM (5.9 vs. 37.1%; p = 0.02), mCRPC (24.0 vs. 62.5%; p < 0.01), and second-line systemic therapy (33.3 vs. 62.5%; p < 0.01) rates were recorded in the ADT group. No statistically significant difference was recorded for disease progression. ForMCRMs adjusted for the metastatic site and PSA, a higher mCRPC rate was recorded in the ADT group. No statistically significant difference was recorded for disease progression. Treatment-related adverse events occurred in 5 (12.5%) MMT vs. 15 (44.1%) ADT patients (p < 0.01). Conclusions: MMT was associated with lower CSM, mCRPC, and second-line therapy rates. A lower rate of treatment-related adverse events was recorded for the MMT group.

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Endourologic Management of Upper Tract Transitional Cell Carcinoma following Cystectomy and Urinary Diversion

Cited by 8 publications

References 51 publications

A review of the contemporary management of upper urinary tract urothelial carcinoma

A review of the contemporary management of upper urinary tract urothelial carcinoma

Endoscopic management of upper tract transitional cell carcinoma

Oligometastatic Prostate Cancer: A Comparison between Multimodality Treatment vs. Androgen Deprivation Therapy Alone

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