While radical nephroureterectomy represents the gold standard for managing upper-tract urothelial carcinoma, nephron-sparing approaches have increasingly been utilized in the elective setting. Such considerations are accentuated by contemporary studies highlighting sequelae related to chronic kidney disease following nephrectomy. Kidney sparing treatments including segmental ureteral resection and endoscopic ablation may therefore be appropriate in select patients with small, solitary, low-grade upper-tract tumors. Bladder and ipsilateral upper-tract recurrences are frequent after nephron-sparing treatments for UTUC, thereby underscoring the need to maintain strict radiographic and endoscopic surveillance protocols in patients amenable to this rigorous compliance program.
[Show abstract][Hide abstract] ABSTRACT: The gold standard treatment for supravesical urothelial carcinoma has been open radical nephroureterectomy based on the premise that this cancer is a field defect. However, nephroureterectomy is an extensive procedure that may not be tolerated by all patients. Percutaneous and ureteroscopic approaches have been utilized in an attempt to avoid the potential morbidity associated with traditional open surgery. This review provides an update on percutaneous management of upper-tract urothelial transitional-cell cancer based on a review of the pertinent literature.
Journal of Endourology 07/2005; 19(6):658-63. DOI:10.1089/end.2005.19.658 · 1.71 Impact Factor
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