Upper Urinary Tract Carcinoma In Situ: Current Knowledge, Future Direction

Grant P. Redrow, Charles C. Guo, Maurizio A. Brausi, Jonathan A. Coleman, Mario I. Fernandez, Wassim Kassouf, Francis X. Keeley, Vitaly Margulis, Jay D. Raman, Morgan Roupret, Shahrokh F. Shariat, Philippe E. Spiess, George N. Thalmann, Surena F. Matin

Research output: Contribution to journalReview article

11 Citations (Scopus)

Abstract

Purpose Carcinoma in situ of the urinary tract is a high grade form of nonmuscle invasive urothelial cancer. Our understanding of this entity in the upper tract is poor, and case management remains challenging due to knowledge gaps regarding the definition, diagnosis, treatment options and followup of the disease. We reviewed the available literature for similarities and differences between bladder and upper tract carcinoma in situ, and herein summarize the best available data. Materials and Methods We reviewed PubMed® and MEDLINE™ databases from January 1976 through September 2014. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement was used to screen publications. All authors participated in the development of a consensus definition of disease. Results A total of 61 publications were found suitable for this review. All studies were retrospective. Compared to bladder carcinoma in situ, upper tract carcinoma in situ appears to have lower progression rates and improved survival. All available studies demonstrate topical therapy to be effective in treating upper tract carcinoma in situ, with decreased recurrence rates compared to bladder carcinoma in situ. Highlighted areas of current knowledge gaps include variable definitions of disease, methods of drug delivery and ideal treatment course. Improving methods for detection may allow easier diagnosis and more effective treatment. Conclusions Based on the available data, organ preserving therapy with topical agents is an alternative to radical surgery in select patients with upper tract carcinoma in situ, although this method has not been evaluated in prospective trials. A paradigm shift regarding detection and treatment is needed to improve care and allow better renal preservation. A consensus definition of the disease is offered, and several areas of major knowledge gaps and opportunities for future research are identified.

Original languageEnglish (US)
Pages (from-to)287-295
Number of pages9
JournalJournal of Urology
Volume197
Issue number2
DOIs
StatePublished - Feb 1 2017

Fingerprint

Carcinoma in Situ
Urinary Tract
Urinary Bladder
Publications
Therapeutics
Case Management
Direction compound
PubMed
MEDLINE
Meta-Analysis
Consensus
Survival Rate
Retrospective Studies
Databases
Kidney
Recurrence
Pharmaceutical Preparations
Neoplasms

Keywords

  • BCG vaccine
  • carcinoma in situ
  • urinary bladder neoplasms
  • urologic neoplasms

ASJC Scopus subject areas

  • Urology

Cite this

Redrow, G. P., Guo, C. C., Brausi, M. A., Coleman, J. A., Fernandez, M. I., Kassouf, W., ... Matin, S. F. (2017). Upper Urinary Tract Carcinoma In Situ: Current Knowledge, Future Direction. Journal of Urology, 197(2), 287-295. https://doi.org/10.1016/j.juro.2016.03.194

Upper Urinary Tract Carcinoma In Situ : Current Knowledge, Future Direction. / Redrow, Grant P.; Guo, Charles C.; Brausi, Maurizio A.; Coleman, Jonathan A.; Fernandez, Mario I.; Kassouf, Wassim; Keeley, Francis X.; Margulis, Vitaly; Raman, Jay D.; Roupret, Morgan; Shariat, Shahrokh F.; Spiess, Philippe E.; Thalmann, George N.; Matin, Surena F.

In: Journal of Urology, Vol. 197, No. 2, 01.02.2017, p. 287-295.

Research output: Contribution to journalReview article

Redrow, GP, Guo, CC, Brausi, MA, Coleman, JA, Fernandez, MI, Kassouf, W, Keeley, FX, Margulis, V, Raman, JD, Roupret, M, Shariat, SF, Spiess, PE, Thalmann, GN & Matin, SF 2017, 'Upper Urinary Tract Carcinoma In Situ: Current Knowledge, Future Direction', Journal of Urology, vol. 197, no. 2, pp. 287-295. https://doi.org/10.1016/j.juro.2016.03.194
Redrow GP, Guo CC, Brausi MA, Coleman JA, Fernandez MI, Kassouf W et al. Upper Urinary Tract Carcinoma In Situ: Current Knowledge, Future Direction. Journal of Urology. 2017 Feb 1;197(2):287-295. https://doi.org/10.1016/j.juro.2016.03.194
Redrow, Grant P. ; Guo, Charles C. ; Brausi, Maurizio A. ; Coleman, Jonathan A. ; Fernandez, Mario I. ; Kassouf, Wassim ; Keeley, Francis X. ; Margulis, Vitaly ; Raman, Jay D. ; Roupret, Morgan ; Shariat, Shahrokh F. ; Spiess, Philippe E. ; Thalmann, George N. ; Matin, Surena F. / Upper Urinary Tract Carcinoma In Situ : Current Knowledge, Future Direction. In: Journal of Urology. 2017 ; Vol. 197, No. 2. pp. 287-295.
@article{38be4047468d40c4aa74d6842d11bfc8,
title = "Upper Urinary Tract Carcinoma In Situ: Current Knowledge, Future Direction",
abstract = "Purpose Carcinoma in situ of the urinary tract is a high grade form of nonmuscle invasive urothelial cancer. Our understanding of this entity in the upper tract is poor, and case management remains challenging due to knowledge gaps regarding the definition, diagnosis, treatment options and followup of the disease. We reviewed the available literature for similarities and differences between bladder and upper tract carcinoma in situ, and herein summarize the best available data. Materials and Methods We reviewed PubMed{\circledR} and MEDLINE™ databases from January 1976 through September 2014. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement was used to screen publications. All authors participated in the development of a consensus definition of disease. Results A total of 61 publications were found suitable for this review. All studies were retrospective. Compared to bladder carcinoma in situ, upper tract carcinoma in situ appears to have lower progression rates and improved survival. All available studies demonstrate topical therapy to be effective in treating upper tract carcinoma in situ, with decreased recurrence rates compared to bladder carcinoma in situ. Highlighted areas of current knowledge gaps include variable definitions of disease, methods of drug delivery and ideal treatment course. Improving methods for detection may allow easier diagnosis and more effective treatment. Conclusions Based on the available data, organ preserving therapy with topical agents is an alternative to radical surgery in select patients with upper tract carcinoma in situ, although this method has not been evaluated in prospective trials. A paradigm shift regarding detection and treatment is needed to improve care and allow better renal preservation. A consensus definition of the disease is offered, and several areas of major knowledge gaps and opportunities for future research are identified.",
keywords = "BCG vaccine, carcinoma in situ, urinary bladder neoplasms, urologic neoplasms",
author = "Redrow, {Grant P.} and Guo, {Charles C.} and Brausi, {Maurizio A.} and Coleman, {Jonathan A.} and Fernandez, {Mario I.} and Wassim Kassouf and Keeley, {Francis X.} and Vitaly Margulis and Raman, {Jay D.} and Morgan Roupret and Shariat, {Shahrokh F.} and Spiess, {Philippe E.} and Thalmann, {George N.} and Matin, {Surena F.}",
year = "2017",
month = "2",
day = "1",
doi = "10.1016/j.juro.2016.03.194",
language = "English (US)",
volume = "197",
pages = "287--295",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "2",

}

TY - JOUR

T1 - Upper Urinary Tract Carcinoma In Situ

T2 - Current Knowledge, Future Direction

AU - Redrow, Grant P.

AU - Guo, Charles C.

AU - Brausi, Maurizio A.

AU - Coleman, Jonathan A.

AU - Fernandez, Mario I.

AU - Kassouf, Wassim

AU - Keeley, Francis X.

AU - Margulis, Vitaly

AU - Raman, Jay D.

AU - Roupret, Morgan

AU - Shariat, Shahrokh F.

AU - Spiess, Philippe E.

AU - Thalmann, George N.

AU - Matin, Surena F.

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Purpose Carcinoma in situ of the urinary tract is a high grade form of nonmuscle invasive urothelial cancer. Our understanding of this entity in the upper tract is poor, and case management remains challenging due to knowledge gaps regarding the definition, diagnosis, treatment options and followup of the disease. We reviewed the available literature for similarities and differences between bladder and upper tract carcinoma in situ, and herein summarize the best available data. Materials and Methods We reviewed PubMed® and MEDLINE™ databases from January 1976 through September 2014. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement was used to screen publications. All authors participated in the development of a consensus definition of disease. Results A total of 61 publications were found suitable for this review. All studies were retrospective. Compared to bladder carcinoma in situ, upper tract carcinoma in situ appears to have lower progression rates and improved survival. All available studies demonstrate topical therapy to be effective in treating upper tract carcinoma in situ, with decreased recurrence rates compared to bladder carcinoma in situ. Highlighted areas of current knowledge gaps include variable definitions of disease, methods of drug delivery and ideal treatment course. Improving methods for detection may allow easier diagnosis and more effective treatment. Conclusions Based on the available data, organ preserving therapy with topical agents is an alternative to radical surgery in select patients with upper tract carcinoma in situ, although this method has not been evaluated in prospective trials. A paradigm shift regarding detection and treatment is needed to improve care and allow better renal preservation. A consensus definition of the disease is offered, and several areas of major knowledge gaps and opportunities for future research are identified.

AB - Purpose Carcinoma in situ of the urinary tract is a high grade form of nonmuscle invasive urothelial cancer. Our understanding of this entity in the upper tract is poor, and case management remains challenging due to knowledge gaps regarding the definition, diagnosis, treatment options and followup of the disease. We reviewed the available literature for similarities and differences between bladder and upper tract carcinoma in situ, and herein summarize the best available data. Materials and Methods We reviewed PubMed® and MEDLINE™ databases from January 1976 through September 2014. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement was used to screen publications. All authors participated in the development of a consensus definition of disease. Results A total of 61 publications were found suitable for this review. All studies were retrospective. Compared to bladder carcinoma in situ, upper tract carcinoma in situ appears to have lower progression rates and improved survival. All available studies demonstrate topical therapy to be effective in treating upper tract carcinoma in situ, with decreased recurrence rates compared to bladder carcinoma in situ. Highlighted areas of current knowledge gaps include variable definitions of disease, methods of drug delivery and ideal treatment course. Improving methods for detection may allow easier diagnosis and more effective treatment. Conclusions Based on the available data, organ preserving therapy with topical agents is an alternative to radical surgery in select patients with upper tract carcinoma in situ, although this method has not been evaluated in prospective trials. A paradigm shift regarding detection and treatment is needed to improve care and allow better renal preservation. A consensus definition of the disease is offered, and several areas of major knowledge gaps and opportunities for future research are identified.

KW - BCG vaccine

KW - carcinoma in situ

KW - urinary bladder neoplasms

KW - urologic neoplasms

UR - http://www.scopus.com/inward/record.url?scp=85008173554&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85008173554&partnerID=8YFLogxK

U2 - 10.1016/j.juro.2016.03.194

DO - 10.1016/j.juro.2016.03.194

M3 - Review article

C2 - 27664578

AN - SCOPUS:85008173554

VL - 197

SP - 287

EP - 295

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 2

ER -