Upper tract urothelial carcinoma: a different disease entity in terms of management.
Upper tract urothelial carcinoma: a different disease entity in terms of management.
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DOI：
10.1136/esmoopen-2016-000126
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发表时间：
2016
期刊：
影响因子：
7.3
通讯作者：
Bellmunt J
中科院分区：
文献类型：
--
作者：
Leow JJ;Chong KT;Chang SL;Bellmunt J
上尿路上皮癌 (UTUC) 占所有尿路上皮癌的 5%–10%，其余为膀胱尿路上皮癌 (UCB)。越来越多的证据表明，基于表型和基因型（遗传和表观遗传）差异，UTUC 是与 UCB 不同的疾病实体。这可能解释了为什么 UTUC 的自然史与 UCB 不同，超过 60% 的 UTUC 和只有 15%–25% 的 UCB 在诊断时表现出浸润。因此，UTUC 的管理在很多方面与 UCB 不同，包括手术管理、术后滴注治疗、术后监测和医疗管理（新辅助和辅助化疗）。本综述旨在强调这些差异，重点关注 UTUC 的独特管理以及最新更新。
Upper tract urothelial carcinomas (UTUCs) consist of 5%–10% of all urothelial carcinomas, the rest being urothelial carcinomas of the bladder (UCB). There is increasing evidence to show that UTUC is a distinct disease entity from UCB based on phenotypical and genotypical (genetic and epigenetic) differences. This may account for why the natural history of UTUC is different from that of UCB, with >60% of UTUCs and only 15%–25% of UCB presenting with invasion at diagnosis. Management of UTUC is thus different from UCB in a variety of ways, ranging from surgical management, postoperative instillation therapy, postoperative surveillance and medical management (neoadjuvant and adjuvant chemotherapy). This review paper aims to highlight these differences with an emphasis on the distinct management of UTUC, along with the latest updates.