Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

UPPER TRACT UROTHELIAL CANCER

Adjuvant and ablative therapies for low-risk UTUC: avenues to enhance kidney preservation

Extirpative surgery for all patients with upper tract urothelial carcinoma (UTUC) risks overtreatment and associated morbidity. Endoscopic approaches are particularly applicable for low-risk disease albeit with the potential for ipsilateral upper tract recurrence. Adjuvant and ablative intracavitary therapies are current and future strategies that could improve disease outcomes and increase adoption of kidney preservation for UTUC.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

  1. Raman, J. D., Messer, J., Sielatycki, J. A. & Hollenbeak, C. S. Incidence and survival of patients with carcinoma of the ureter and renal pelvis in the USA, 1973–2005. BJU Int. 107, 1059–1064 (2011).

    Article  Google Scholar 

  2. Seisen, T. et al. Oncologic outcomes of kidney sparing surgery versus radical nephroureterectomy for the elective treatment of clinically organ confined upper tract urothelial carcinoma of the distal ureter. J. Urol. 195, 1354–1361 (2016).

    Article  Google Scholar 

  3. Roupret, M. et al. European Association of Urology guidelines on upper urinary tract urothelial carcinoma: 2017 update. Eur. Urol. 73, 111–122 (2018).

    Article  Google Scholar 

  4. Upfill-Brown, A. et al. Treatment utilization and overall survival in patients receiving radical nephroureterectomy versus endoscopic management for upper tract urothelial carcinoma: evaluation of updated treatment guidelines. World J. Urol. 37, 1157–1164 (2019).

    Article  Google Scholar 

  5. Margulis, V. et al. Outcomes of radical nephroureterectomy: a series from the Upper Tract Urothelial Carcinoma Collaboration. Cancer 115, 1224–1233 (2009).

    Article  Google Scholar 

  6. Petros, F. G. Preoperative multiplex nomogram for prediction of high-risk nonorgan-confined upper-tract urothelial carcinoma. Urol. Oncol. 37, 292.e1–292.e9 (2019).

    Article  Google Scholar 

  7. Petros, F. G., Li, R. & Matin, S. F. Endoscopic approaches to upper tract urothelial carcinoma. Urol. Clin. North Am. 45, 267–286 (2018).

    Article  Google Scholar 

  8. Chang, S. S. et al. Diagnosis and treatment of non-muscle invasive bladder cancer: AUA/SUO Guideline. J. Urol. 196, 1021–1029 (2016).

    Article  Google Scholar 

  9. Gallioli, A. et al. Adjuvant single-dose upper urinary tract instillation of mitomycin C after therapeutic ureteroscopy for upper tract urothelial carcinoma: a single-centre prospective non-randomized trial. J. Endourol. https://doi.org/10.1089/end.2019.0750 (2020).

    Article  PubMed  Google Scholar 

  10. Kleinmann, N. et al. Primary chemoablation of low-grade upper tract urothelial carcinoma using UGN-101, a mitomycin-containing reverse thermal gel (OLYMPUS): an open-label, single-arm, phase 3 trial. Lancet Oncol. https://doi.org/10.1016/S1470-2045(20)30147-9 (2020).

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jay D. Raman.

Ethics declarations

Competing interests

J.D.R. declares that he is a study site investigator for the OLYMPUS trial (NCT02793128) and a member of the strategic advisory board for Urogen Pharma Ltd.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Raman, J.D. Adjuvant and ablative therapies for low-risk UTUC: avenues to enhance kidney preservation. Nat Rev Urol 17, 433–434 (2020). https://doi.org/10.1038/s41585-020-0338-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41585-020-0338-4

Search

Quick links

Nature Briefing: Cancer

Sign up for the Nature Briefing: Cancer newsletter — what matters in cancer research, free to your inbox weekly.

Get what matters in cancer research, free to your inbox weekly. Sign up for Nature Briefing: Cancer