Current Status in the Surgery and Conservative Management of Upper Urinary System Tumors
Journal Title: Üroonkoloji Bülteni - Year 2018, Vol 17, Issue 4
Abstract
Upper urinary tract urothelial cancers constitute 5% of all urothelial cancers and standard therapy is bladder cuff excision with nephroureterectomy. This treatment is performed as open or technologically assisted (laparoscopic and robotic) surgery. Conservative treatment approaches include endoscopic treatments, segmental resection, and upper urinary tract immunotherapy. Upper urinary tract immunotherapy is considered effective in patients with carcinoma in situ. In addition, the development of targeted molecules and gene therapies is also anticipated. In selected patient groups, endoscopic (antegrade percutaneous and retrograde ureteroscopic) procedures are being implemented as an alternative to nephroureterectomy in order to prevent unnecessary organ loss and to preserve the nephrons. Oncological survival and tumor control with the endoscopic approach are similar to the outcomes of radical surgery in cases with low-stage and grade tumors. Advantages of the endoscopic approach include minimal morbidity and preservation of kidney function, while disadvantages include life-long follow-up and the need for a large number of endoscopies. In cases with a large tumor burden, the retrograde ureteroscopic approach is generally preferred instead of percutaneous treatment.
Authors and Affiliations
Serdar Geyik
Keywords
Related Articles
- EP ID EP437629
- DOI 10.4274/uob.1119
- Views 95
- Downloads 0
Editorial
.
Gleason Score Correlation Between Prostate Biopsy and Radical Prostatectomy Specimens
Objective: Prostate cancer is the most common malignancy in men and the second cause of cancer-related mortality. Prostate biopsy and the Gleason score guide treatment decisions in prostate cancer. Several studies have i...
Information about Prostate Cancer for Urologist: Ga-68 Prostate Specific Membrane Antigen Positron Emission Tomography/Computed Tomography Scintigraphy
Recently, prostate-specific membrane antigen (PSMA), a glutamate carboxypeptidase II enzyme, has transformed intoan excited radiopharmaceutical agent as a result of radiolabeling of small peptides that are developed for...
Controversies in Radical Cystectomy: Meta-Analysis and Systemic Comparison of Open Surgery with Laparoscopic and Robotic Surgery
Open radical cystectomy (ORC) is the standard treatment modality in high-risk non-muscle-invasive and invasive bladder carcinoma. Although it has some advantages, oncologic outcomes of ORC are associated with high morbid...
Is Prostate Cancer Related to Low Vitamin D Level?
Objective: Prostate cancer (PC) is the most common malignancy among men worldwide. There are several epidemiological studies linking the risk and outcome of vitamin D with PC. In this study, we aimed to compare vitamin D...