Percutaneous Management of Transitional Cell Carcinoma of the Renal Collecting System: 9-Year Experience

Abstract

With vigilant followup, percutaneous management of transitional cell carcinoma of the renal collecting system is an acceptable alternative to nephroureterectomy in patients with grade 1 disease, grade 2 disease who are at risk for renal insufficiency and medical contraindications to a major open operation.

Renal imaging: what the urologist wants to know

“…Tawfiek and Bagley [56] reported an overall recurrence rate of renal pelvic tumors of approximately 31%, stressing the importance of strict surveillance. As expected, recurrence rates are higher for higher-grade tumors [58].…”

Percutaneous Treatment of Transitional Cell Carcinoma of the Upper Urinary Tract

“…It seems rational that percutaneous resection of upper urinary tract transitional cell carcinoma should be limited to patients with grade 1 or 2 carcinoma. This conclusion was also supported by the report written by Jarrett et a1., 8 bacillus Calmette-Guerin or mitomycin C to prevent recurrence. No definite conclusion as to the efficacy of this approach can b e drawn until additional case studies with long follow-up period are available.…”

Intracavitary Therapy of Noninvasive Transitional Cell Carcinomas of the Upper Urinary Tract

“…While there are few reports in the literature about the use of chemotherapeutic agents such as thiotepa [14,15] and mitomycin C (MMC) [16][17][18], the use of bacillus Calmette-Guérin (BCG) is more diffuse [19,20]. A review of the current data published in the literature is reported here: indications, treatment modalities, therapeutic impact and treatment-related side effects are critically reviewed.…”

“…Due to the appealing results, BCG intracavitary therapy gained interest and was then used as prophylaxis by some authors in pilot trials [19,20,[33][34][35][36] after anterograde or retrograde endourological treatment of papillary tumors or as therapy for residual disease [2, 32,34,35,[37][38][39][40], particularly carcinoma in situ [37][38][39][40][41].…”

“…The instillation of BCG in the upper urinary tract may be anterograde via a percutaneous nephrostomy tube [20,[32][33][34][35], retrograde via a single-J ureteral stent [3, 36,38] or by reflux of the ureteral orifice and positioning of an indwelling double-J ureteral stent [3, 33,36,38,39].…”