Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Zigeuner, R; Pummer, K.
Urothelial carcinoma of the upper urinary tract: surgical approach and prognostic factors.
EUR UROL. 2008; 53(4): 720-731.
Doi: 10.1016/j.eururo.2008.01.006
Web of Science
PubMed
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- Führende Autor*innen der Med Uni Graz
- Zigeuner Richard
- Co-Autor*innen der Med Uni Graz
- Pummer Karl
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- Abstract:
- OBJECTIVES: Open radical nephroureterectomy (O-RNU) has been the gold standard for the treatment of upper urinary tract urothelial carcinoma (UUT-UC) for decades. With the advances in laparoscopic techniques and endourologic procedures, this concept has been increasingly challenged. Oncologic outcome prediction is mainly based on stage and grade. With progress in medical treatment, adjuvant therapies may gain importance in the future. This review assesses the values of the variety of available treatments as well as prognostic factors that may become relevant regarding patient selection for future adjuvant treatment trials. METHODS: We performed a systematic literature research using MEDLINE with emphasis on open surgical, laparoscopic, and endourologic (ureteroscopic or percutaneous) techniques and prognostic contents. RESULTS: Overall, no evidence level 1 information from prospective randomised trials is available for treatment of UUT-UC. Laparoscopic radical nephroureterectomy (L-RNU) is increasingly challenging open surgery. Currently, L-RNU should be reserved for low-stage, low-grade tumours. Ureteroscopy and percutaneous nephron-sparing techniques show favourable survival data but high local recurrence rates. Regarding prognosis, estimation of outcome still relies mainly on stage and grade because no additional parameters have been introduced in a routine clinical setting. CONCLUSIONS: O-RNU still represents the gold standard for the treatment of UUT-UC. The laparoscopic approach is not yet standard of care and should be reserved for low-stage, low-grade tumours. Endourologic nephron-sparing treatments are still experimental in elective indications due to high local recurrence rates. For prognosis, no parameters in addition to stage and grade have been standardised.
- Find related publications in this database (using NLM MeSH Indexing)
- Carcinoma - surgery
- Humans -
- Kidney Neoplasms - surgery
- Nephrectomy - methods
- Prognosis -
- Survival Analysis -
- Ureteral Neoplasms - surgery
- Ureteroscopy -
- Find related publications in this database (Keywords)
- endourology
- laparoscopy
- pathology
- percutaneous
- prognosis
- surgery
- upper urinary tract
- ureteroscopy
- urothelial cancer