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Upper tract urothelial carcinoma

Jaime A Singh, Chisato Ohe, Steven Christopher Smith
Collecting duct carcinoma was described over 30 years ago as a renal tumor, based in the medullary collecting system, with tubulopapillary morphology, prominent infiltrative growth, and stromal desmoplasia. While diagnostic workup has always emphasized exclusion of upper tract urothelial carcinoma and metastatic adenocarcinoma to the kidney, the molecular era of renal cell carcinoma classification has enabled recognition of and provided tools for diagnosis of new entities in this morphologic differential. In this review, we consider these developments, with emphasis on renal medullary carcinoma, closely related renal cell carcinoma, unclassified with medullary phenotype, and fumarate hydratase-deficient renal cell carcinoma...
April 17, 2018: Pathology International
Simone Bier, Jörg Hennenlotter, Michael Esser, Sarah Mohrhardt, Steffen Rausch, Christian Schwentner, Moritz Maas, Susanne Deininger, Simon Walz, Jens Bedke, Arnulf Stenzl, Tilman Todenhöfer
Objectives: To assess the performance of urine markers determined in urine samples from the bladder compared to samples collected from the upper urinary tract (UUT) for diagnosis of UUT urothelial carcinoma (UC). Patients and Methods: The study comprised 758 urine samples either collected from the bladder ( n = 373) or UUT ( n = 385). All patients underwent urethrocystoscopy and UUT imaging or ureterorenoscopy. Cytology, fluorescence in situ hybridization (FISH), immunocytology (uCyt+), and nuclear matrix protein 22 (NMP22) were performed...
2018: Disease Markers
Min Yuen Teo, Jonathan E Rosenberg
Neoadjuvant chemotherapy improves survival in patients with muscle-invasive bladder cancer. However, a significant proportion of patients are ineligible for cisplatin owing to renal impairment or other medical comorbidities. The introduction of anti-programmed cell death protein 1/programmed death-ligand 1(PD1/PD-L1) checkpoint inhibitors has redefined the therapeutic landscape for platinum-resistant urothelial cancers; their clinical efficacy and favorable toxicity render these agents attractive therapeutic options either as monotherapy or in combination with other agents in earlier disease states, including muscle-invasive disease...
May 2018: Urologic Clinics of North America
Firas G Petros, Roger Li, Surena F Matin
A select group of patients with upper tract urothelial carcinoma (UTUC) may meet indications for endoscopic management. Strategies for disease management are provided, based on a comprehensive review of the data using PubMed and Medline databases and marrying this with our experience with endoscopic management of UTUC. Endoscopic management of UTUC via retrograde or antegrade approaches is a viable treatment option for appropriately selected patients with low-risk UTUC, including those with low-grade, low-volume, and solitary tumors...
May 2018: Urologic Clinics of North America
Tala Achkar, Rahul A Parikh
This article summarizes the role of adjuvant chemotherapy in muscle-invasive and transitional cell carcinoma of the bladder and upper urinary tract.
May 2018: Urologic Clinics of North America
Niranjan J Sathianathen, Michael C Risk, Badrinath R Konety
There are currently no reported randomized trials that characterize the staging or therapeutic benefit of performing a lymph node dissection in either bladder cancer or upper tract urothelial carcinoma. Several unanswered questions remain in this domain focused on the indications and patient selection for pelvic lymph node dissection, extent of dissection, its impact on outcome, and potential risks. However, the results of observational studies suggest that the burden of metastasis is high in both diseases when muscle invasive and performing a lymphadenectomy can provide prognostic information and yield therapeutic benefit...
May 2018: Urologic Clinics of North America
Benjamin L Taylor, Douglas S Scherr
Upper tract urothelial carcinoma is a rare malignancy that has an abundance of surgical treatment options, including open, laparoscopic, robotic, and endoscopic approaches. As advances in technology allow for shorter, less morbid operations, the variation in care of this uncommon disease has raised concerns about compromising oncologic principles. Many institutions have described their experience with promising results; however, there is a paucity of high-quality data that supports the use of robotic surgery as a new gold standard...
May 2018: Urologic Clinics of North America
William Tabayoyong, Roger Li, Jianjun Gao, Ashish Kamat
Radical cystectomy with bilateral pelvic lymph node dissection is the standard of care for patients with clinically localized muscle-invasive bladder cancer. Survival after radical cystectomy is associated with final pathologic staging. Survival decreases with increasing pT stage because of the presence of occult micrometastases, indicating the need for systemic chemotherapy. Systemic chemotherapy is delivered as either neoadjuvant therapy preoperatively, or as adjuvant therapy postoperatively. This article reviews the evidence for neoadjuvant and adjuvant chemotherapy for the treatment of muscle-invasive bladder and upper tract urothelial cancer and offers recommendations based on these data and recently updated clinical guidelines...
May 2018: Urologic Clinics of North America
Matthew Mossanen, Steven L Chang, Simon Kimm, Guru P Sonpavde, Adam S Kibel
Please note, the synopsis was used from your supplied original manuscript, and not the accompanying abstract, per journal style: This article discusses current staging strategies in muscle-invasive bladder cancer and upper tract urothelial cell carcinoma. Current staging methods can help identify patients with localized or metastatic disease but are subject to limitations which must be considered.
May 2018: Urologic Clinics of North America
Wen-Kuei Fang, Yeong-Chin Jou, Yuan-Chang Dai, Pi-Chan Ko, Ya-Fang Huang
Upper tract urothelial cancer (UTUC) arises from the urothelial lining of the urinary tract. UTUC spreads in several different ways including direct invasion, lymphatic spread, and hematogeneous metastases. Regional lymph nodes are commonly the initial site of metastasis, followed by the liver, lung, and bone. Brain metastasis is uncommon in patients with urothelial carcinoma. Here, we report an uncommon case of kidney urothelial carcinoma with brain metastasis in a 55-year-old woman presenting with dysarthria with right side limb weakness...
January 2018: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
Matthew R Danzig, Katherine Mallin, James M McKiernan, Walter M Stadler, Srikala S Sridhar, Todd M Morgan, Bernard H Bochner, Cheryl T Lee
BACKGROUND: The current study was conducted to assess the impact of lymphovascular invasion on the survival of patients with urothelial carcinoma of the renal pelvis. METHODS: Patients with urothelial carcinoma of the renal pelvis who underwent radical nephroureterectomy from 2010 through 2015 were identified in the National Cancer Data Base. Patients were characterized according to demographic and clinical factors, including pathologic tumor stage and lymphovascular invasion...
April 6, 2018: Cancer
Hiroshi Fukushima, Masaki Kobayashi, Keizo Kawano, Shinji Morimoto
BACKGROUND/AIM: We investigated the prognostic role of the albumin/globulin ratio (AGR) in patients with upper tract urothelial carcinoma (UTUC) undergoing radical nephroureterectomy (RNU). PATIENTS AND METHODS: AGR was calculated as follows: AGR=serum albumin/(serum total protein-serum albumin). Associations of preoperative AGR with disease-free (DFS) and overall (OS) survival were assessed in 105 patients with UTUC undergoing RNU. RESULTS: Patients with preoperative AGR <1...
April 2018: Anticancer Research
Dong Fang, Shiming He, Gengyan Xiong, Nirmish Singla, Zhenpeng Cao, Lei Zhang, Xuesong Li, Liqun Zhou
BACKGROUND: There's no consensus about the difference between renal pelvic and ureteral tumors in terms of clinical features, pathological outcomes, epigenetic biomarkers and prognosis. METHODS: The data of 341 patients with renal pelvic tumors and 271 patients with ureteral tumors who underwent radical nephroureterectomy between 1999 and 2011 were retrospectively reviewed. The clinicopathologic features, gene promoters methylation status and oncologic outcomes were compared...
March 27, 2018: BMC Urology
Bao Guan, Yicong Du, Xiaohong Su, Zhenpeng Cao, Yifan Li, Yonghao Zhan, Ding Peng, Gengyan Xiong, Dong Fang, Yi Ding, Shiming He, Yanqing Gong, Qun He, Xuesong Li, Liqun Zhou
Here, we evaluated the potential contribution of fluorescent in situ hybridization (FISH) as a prognostic risk factor of bladder recurrence and survival in patients with upper tract urothelial carcinoma (UTUC). A total of 159 UTUC patients were enrolled in this study from January 2012 to May 2016. The 159 voided urine samples before surgery were analyzed using the UroVysion® kit to detect the copy numbers of chromosomes 3, 7, 17 and 9p21 (p16). Patients were classified using an optimal cutoff value of chromosomes 3, 7, 17, and 9p21...
March 6, 2018: Oncotarget
Lorenzo Defidio
No abstract text is available yet for this article.
March 25, 2018: International Journal of Urology: Official Journal of the Japanese Urological Association
J V Baldissera Aradas, L Rodríguez Villamil, S Fernández-Pello Montes, R Gil Ugarteburu, J Mosquera Madera
BACKGROUND: The ureteral disinsertion with bladder cuff technique continues to evolve. We present the endoscopic laser transurethral technique combined with a transperitoneal and retroperitoneal laparoscopic approach in lateral decubitus, without patient repositioning, for treating urothelial carcinomas of the upper urinary tract. MATERIALS AND METHODS: We present 3 laparoscopic nephroureterectomies: 1 transperitoneal and 2 retroperitoneal. Disinsertion was performed in lateral decubitus using a flexible cystoscope and a 365-μm holmium laser fiber...
March 22, 2018: Actas Urologicas Españolas
Junhun Cho, Sang Yun Ha, Seok-Hyung Kim, Hyun Hwan Sung, Ghee Young Kwon
Epithelial-mesenchymal transition (EMT) is a process which epithelial cells gain mesenchymal phenotype such as motility and invasiveness. We investigated the role of EMT in upper urinary tract urothelial carcinoma (UTUC). The patient cohort included 93 cases of UTUC treated with radical nephroureterectomy. Tissue microarrays were constructed from formalin-fixed paraffin-embedded tissue blocks. Immunohistochemical staining was performed for E-cadherin, vimentin, and smooth muscle actin to evaluate the EMT status...
February 14, 2018: Pathology, Research and Practice
S Bourgeois, M Decupere, D Devriendt, K Lesage, W Van Moerkercke
A 64-year old woman was admitted to the hospital for severe abdominal pain and distension after gardening and chopping wood the day before. She had a medical history of superficial transitional cell carcinoma (TCC) of the urinary bladder and a laparoscopic nefro-ureterectomy for an invasive TCC of the upper urothelial tract in 2012. Clinical examination showed an acute abdomen. Laboratory analysis revealed a plasma creatinine level of 4,23 mg/dl. Computed tomography (CT) imaging of the abdomen showed hypodense free intraperitoneal fluid, suspicious for ascites...
July 2017: Acta Gastro-enterologica Belgica
Hamid Emamekhoo, Puneet Dhillon, Dharmesh Gopalakrishnan, Paul Elson, Andrew Stephenson, Cristina Magi-Galluzzi, Jesse McKenney, Holly Harper, Georges-Pascal Haber, Jihad Kaouk, Byron Lee, Amr Fergany, Ryan Berglund, Michael Gong, Robert Stein, Venkatesh Krishnamurthi, Timothy Gilligan, Moshe Ornstein, Brian Rini, Jorge Garcia, Petros Grivas
BACKGROUND: Upper tract urothelial carcinoma (UTUC) accounts for approximately 5% of all urothelial cancers. Because of similarities in morphology and histology between UTUC and urothelial carcinoma of the bladder, most treatment guidelines used for UTUC are extrapolated from the urothelial bladder carcinoma setting. With the emergence of new treatment modalities, such as immunotherapy, UTUC-specific prognostic and predictive models are needed. PATIENTS AND METHODS: A retrospective study of 454 UTUC patients who received surgery at Cleveland Clinic (1995-2014) was conducted...
February 6, 2018: Clinical Genitourinary Cancer
Chihyun Ahn, Chang Wook Jeong, Cheol Kwak, Hyeon Hoe Kim, Hyung Suk Kim, Ja Hyeon Ku
BACKGROUND: We systematically evaluated the prognostic significance of Ki-67 on survival outcomes in patients with upper urinary tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU). MATERIALS AND METHODS: We searched the Embase, Scopus, and PubMed databases for all articles published up to February 2017 by following the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines. The outcomes of interest included intravesical recurrence (IVR)-free survival, disease-free survival (DFS), cancer-specific survival (CSS), and overall survival (OS)...
February 24, 2018: Clinical Genitourinary Cancer
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