Kidney-sparing surgery for upper tract urothelial cancer.

Détails

ID Serval
serval:BIB_FD37600480F3
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Kidney-sparing surgery for upper tract urothelial cancer.
Périodique
Current Opinion in Urology
Auteur(s)
Lucca I., Klatte T., Rouprêt M., Shariat S.F.
ISSN
1473-6586 (Electronic)
ISSN-L
0963-0643
Statut éditorial
Publié
Date de publication
2015
Peer-reviewed
Oui
Volume
25
Numéro
2
Pages
100-104
Langue
anglais
Notes
Publication types: Journal Article Publication Status: ppublish Document type : review
Résumé
PURPOSE OF REVIEW: This article reviews and summarizes current knowledge on kidney-sparing surgery (KSS) for upper tract urothelial carcinoma (UTUC).
RECENT FINDINGS: Radical nephroureterectomy (RNU) has been central to the treatment of UTUC for decades, but KSS has been applied to a rising number of patients to preserve renal function. Ablation or resection through flexible ureteroscopy or the percutaneous route seems to provide comparable cancer-specific survival and overall survival to RNU, but the risk of local and bladder recurrence remains relatively high. Segmental ureterectomy is used for low-risk unifocal UTUC with recent studies confirming its oncologic safety and equivalence to RNU. Antegrade or retrograde instillation therapy may be considered as adjuvant treatment after conservative surgery, but their efficacy needs to be proven. Intravesical single-dose chemotherapy is likely to become part of the therapy algorithm of UTUC treated by KSS or RNU to lower bladder seeding and recurrence. Postoperative vigilant radiographic and endoscopic surveillance are obligatory because of the high probability of recurrence.
SUMMARY: KSS should be regarded as a valid alternative to RNU in case of technically resectable low-risk upper tract urothelial cell carcinoma, even in case of a normal contralateral kidney. Advances in technology and biological and clinical risk estimation will make the management of UTUC more evidence based thereby lowering overtreatment.
Pubmed
Web of science
Création de la notice
13/03/2015 19:21
Dernière modification de la notice
20/08/2019 17:28
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