Current Evidence and Future Perspectives in the Management of Nonmetastatic Upper Tract Urothelial Carcinoma

Eur Urol Oncol. 2022 Aug;5(4):464-471. doi: 10.1016/j.euo.2021.09.002. Epub 2021 Sep 22.


This case-based discussion describes the management of a 66-yr-old man who presented to the emergency department with gross hematuria. His urine cytology was benign, and computed tomography (CT) with nephrographic phase revealed a 2.5 cm filling defect within the left renal pelvis and luminal narrowing in the right proximal ureter with hydronephrosis. CT showed no lymphadenopathy and no sign of metastatic disease. Cystoscopy was normal. In a progressive case-based discussion fashion, we will discuss the diagnostic and treatment options with two different perspectives: (1) guidelines-based current standard of care and (2) an outlook on future perspectives using the latest scientific advances that may soon become the standard of care. PATIENT SUMMARY: This presentation of a real-life clinical scenario will be useful in describing the current standard of care and future perspectives regarding the diagnosis and treatment of upper urinary tract tumors.

Keywords: Conservative management; Immunotherapy; Kidney-sparing strategies; Robotic radical nephroureterectomy; Upper urinary tract tumor; Urinary biomarkers.

MeSH terms

  • Carcinoma, Transitional Cell* / diagnosis
  • Carcinoma, Transitional Cell* / pathology
  • Carcinoma, Transitional Cell* / therapy
  • Cystoscopy
  • Humans
  • Male
  • Ureter* / pathology
  • Urinary Bladder Neoplasms*
  • Urologic Neoplasms* / diagnosis
  • Urologic Neoplasms* / therapy