Management of Upper Tract Urothelial Carcinoma

Curr Oncol Rep. 2022 May;24(5):611-619. doi: 10.1007/s11912-021-01179-8. Epub 2022 Feb 25.


Purpose of review: We review the epidemiology, risk factors, diagnosis, and treatment of upper tract urothelial carcinoma (UTUC), with a distinction between the different risk groups.

Recent findings: Endoscopic treatment with laser ablation of tumors has an evolving role in treating low-grade UTUC including select large and multifocal tumors, along with complementary topical chemotherapeutic treatment that can reach difficult intrarenal locations. Template lymphadenectomy is recommended in patients undergoing nephroureterectomy. A recent randomized control trial showed benefit of adjuvant chemotherapy after radical nephroureterectomy for locally advanced disease. Advances in immunologic therapy have shown promise in treating metastatic UTUC, and immunologic-based therapies have been incorporated into treatment regimens. Notable progress has been made in both the surgical and medical treatment arms for UTUC, thus extending the reach of nephron-sparing therapy for those with localized disease and increasing overall survival for those with locally advanced disease.

Keywords: Laser ablation; Nephron-sparing surgery; Nephroureterectomy; Systemic chemotherapy; Topical chemotherapy; Upper tract urothelial carcinoma; Ureteroscopy.

Publication types

  • Review

MeSH terms

  • Carcinoma, Transitional Cell* / drug therapy
  • Chemotherapy, Adjuvant
  • Female
  • Humans
  • Lymph Node Excision
  • Male
  • Nephroureterectomy
  • Urinary Bladder Neoplasms* / drug therapy