Epidemiology, diagnosis, preoperative evaluation and prognostic assessment of upper-tract urothelial carcinoma (UTUC)

Upper-tract urothelial carcinoma (UTUC) is a relatively uncommon disease with limited available evidence on specific topics. The purpose of this article was to review the previous literature to summarize the current knowledge about UTUC epidemiology, diagnosis, preoperative evaluation and prognostic assessment.

Using MEDLINE, a non-systematic review was performed including articles between January 2000 and February 2016. English language original articles, reviews and editorials were selected based on their clinical relevance.

UTUC accounts for 5-10 % of all urothelial cancers, with an increasing incidence. UTUC and bladder cancer share some common risk factors, even if they are two different entities regarding practical, biological and clinical characteristics. Aristolochic acid plays an important role in UTUC pathogenesis in certain regions. It is further estimated that approximately 10 % of UTUC are part of the hereditary non-polyposis colorectal cancer spectrum disease. UTUC diagnosis remains mainly based on imaging and endoscopy, but development of new technologies is rapidly changing the diagnosis algorithm. To help the decision-making process regarding surgical treatment, extent of lymphadenectomy and selection of neoadjuvant systemic therapies, predictive tools based on preoperative patient and tumor characteristics have been developed.

Awareness regarding epidemiology, diagnosis, preoperative evaluation and prognostic assessment changes is essential to correctly diagnose and manage UTUC patients, thereby potentially improving their outcomes.

World journal of urology. 2016 Sep 07 [Epub ahead of print]

Francesco Soria, Shahrokh F Shariat, Seth P Lerner, Hans-Martin Fritsche, Michael Rink, Wassim Kassouf, Philippe E Spiess, Yair Lotan, Dingwei Ye, Mario I Fernández, Eiji Kikuchi, Daher C Chade, Marko Babjuk, Arthur P Grollman, George N Thalmann

Department of Urology, Medical University of Vienna, Vienna, Austria., Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA., Department of Urology, Caritas St. Josef Medical Centre, University of Regensburg, Regensburg, Germany., Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Department of Surgery (Urology), McGill University, Montreal, QC, Canada., Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA., Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA., Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China., Department of Urology, Clinica Alemana, Santiago, Chile., Department of Urology, Keio University School of Medicine, Tokyo, Japan., Urology Department, University of Sao Paulo Medical School and Institute of Cancer, São Paulo, Brazil., Department of Urology, Faculty Hospital Motol, Second Faculty of Medicine, Charles University in Praha, Prague, Czech Republic., Department of Pharmacological Sciences and Department of Medicine, Stony Brook University, Stony Brook, NY, USA., Department of Urology, Bern University Hospital, Bern, Switzerland. .