Ureteroscopic Management of Patients with Upper Tract Transitional Cell Carcinoma

摘要

Objectives: This paper reviews the indications, technique, and treatment outcomes for the ureteroscopic management of upper tract transitional cell carcinomas (UTTCCs). Methods: The author reports on his experience and reviews of the most recent data published in the literature. Results: The expanding experience with minimally invasive techniques to treat UTTCCs has demonstrated its safety and efficacy in selected patients. Diagnostic accuracy can be enhanced and pathologic confirmation of tumour grade and stage can be regularly obtained. In selected patients with unique, small tumours with low grade and low stage, the results of endoscopic management are encouraging. Patients with a functional solitary kidney, bilateral disease, or renal insufficiency can also be considered for conservative treatment. The patient must be willing to and capable of undergoing vigilant and frequent endoscopies during the follow-up. However, conservative management remains controversial in a patient with low-grade/low-stage disease and a normal contralateral kidney. Conclusions: Ureteroscopic management of UTTCC is feasible and safe using, preferably, laser fulguration.