Conservative nephron-sparing treatment of upper-tract tumors.
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.
Division of Urology, Penn State Milton S. Hershey Medical Center, 500 University Drive, c4830B, Hershey, PA 17033, USA.
Paul
P
Smith
Juliette
J
Mandel
Jay D
JD
Raman
D000287:Administration, Topical; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001500:BCG Vaccine / Q000627:therapeutic use; D002295:Carcinoma, Transitional Cell / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D006801:Humans; D007680:Kidney Neoplasms / Q000628:therapy*; D007682:Kidney Pelvis; D016685:Mitomycin / Q000627:therapeutic use; D009399:Nephrons; D059351:Organ Sparing Treatments / Q000379:methods*; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*; D014516:Ureteral Neoplasms / Q000628:therapy*; D018666:Ureteroscopy
D000970:Antineoplastic Agents; D001500:BCG Vaccine; D016685:Mitomycin