The role of systemic chemotherapy in management of upper tract urothelial cancer

Bishoy A. Gayed, Gregory R. Thoreson, Vitaly Margulis

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Upper tract urothelial cancer (UTUC) accounts for roughly 5 % of all urothelial cancers. At presentation, 30 % of patients demonstrate invasive and/or locally advanced disease, 30-40 % have regional lymph node involvement, and 20 % harbor metastatic disease. Systemic recurrence and progression rates after surgery for patients with advanced disease range between 45-60 %. Five-year cancer specific survival rates for pT2 and pT3 tumors are 73 % and 40 %, respectively. Median survival for patients with pT4 disease is approximately 6 months. Nonetheless, there is a lack of improvement in the rates of systemic recurrence and progression in patients with advanced UTUC. Extrapolating evidence obtained from experience with multi-modal therapy of patients with urothelial bladder cancer, additional improvements in oncological outcomes for patients with UTUC can be achieved through integration of effective systemic chemotherapy with local tumor control. We provide an overview of the rationale and utilization strategies of peri-operative systemic chemotherapy in patients with UTUC.

Original languageEnglish (US)
Pages (from-to)94-101
Number of pages8
JournalCurrent urology reports
Volume14
Issue number2
DOIs
StatePublished - Apr 2013

Keywords

  • Adjuvant chemotherapy
  • Neoadjuvant chemotherapy
  • Nephro-ureterectomy
  • Oncologic outcomes
  • Risk stratification
  • Upper urinary tract urothelial cancer

ASJC Scopus subject areas

  • Urology

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