title: Intracavitary immunotherapy and chemotherapy for upper urinary tract cancer: current evidence.
abstract: A review of the literature was performed to summarize current evidence regarding the efficacy of topical immunotherapy and chemotherapy for upper urinary tract urothelial cell carcinoma (UUT-UCC) in terms of post-treatment recurrence rates. A Medline database literature search was performed in March 2012 using the terms upper urinary tract, urothelial cancer, bacillus Calmette-Guérin (BCG), and mitomycin C. A total of 22 full-text articles were assessed for eligibility, and 19 studies reporting the outcomes of patients who underwent immunotherapy or chemotherapy with curative or adjuvant intent for UUT-UCC were chosen for quantitative analysis. Overall, the role of immunotherapy and chemotherapy for UUT-UCC is not firmly established. The most established practice is the treatment of carcinoma in situ (CIS) with BCG, even if a significant advantage has not yet been proven. The use of BCG as adjuvant therapy after complete resection of papillary UUT-UCC has been studied less extensively, even if recurrence rates are not significantly different than after the treatment of CIS. Only a few reports describe the use of mitomycin C, making it difficult to obtain significant evidence.
authors.affiliation: Università degli Studi di Milano, Urology Department, IRCCS Policlinico San Donato, San Donato Milanese, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Carmignani
authors.affiliation: Università degli Studi di Milano, Urology Department, European Institute of Oncology Milan, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bianchi
authors.affiliation: Università degli Studi di Milano, Urology Department, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico Milan, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Cozzi
authors.affiliation: Università degli Studi di Milano, Urology Department, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico Milan, Italy.
authors.forename: Angelica
authors.initials: A
authors.lastname: Grasso
authors.affiliation: Università degli Studi di Milano, Urology Department, S. Paolo Hospital Milan, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Macchione
authors.affiliation: Università degli Studi di Milano, Urology Department, IRCCS Policlinico San Donato, San Donato Milanese, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Marenghi
authors.affiliation: Università degli Studi di Milano, Urology Department, European Institute of Oncology Milan, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Melegari
authors.affiliation: Università degli Studi di Milano, Urology Department, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico Milan, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Rosso
authors.affiliation: Università degli Studi di Milano, Urology Department, IRCCS S. Giuseppe Hospital Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Tondelli
authors.affiliation: Università degli Studi di Milano, Urology Department, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico Milan, Italy.
authors.forename: Augusto
authors.initials: A
authors.lastname: Maggioni
keywords: Bacillus Calmette-Guérin; Chemotherapy; Immunotherapy; Mitomycin C; Upper urinary tract; Urothelial cell carcinoma