Soria Francesco, Shariat Shahrokh F, Lerner Seth P, Fritsche Hans-Martin, Rink Michael, Kassouf Wassim, Spiess Philippe E, Lotan Yair, Ye Dingwei, Fernández Mario I, Kikuchi Eiji, Chade Daher C, Babjuk Marko, Grollman Arthur P, Thalmann George N
Department of Urology, Medical University of Vienna, Vienna, Austria.
Division of Urology, Department of Surgical Sciences, San Giovanni Battista Hospital, University of Studies of Torino, Turin, Italy.
World J Urol. 2017 Mar;35(3):379-387. doi: 10.1007/s00345-016-1928-x. Epub 2016 Sep 7.
Upper-tract urothelial carcinoma (UTUC) is a relatively uncommon disease with limited available evidence on specific topics. The purpose of this article was to review the previous literature to summarize the current knowledge about UTUC epidemiology, diagnosis, preoperative evaluation and prognostic assessment.
Using MEDLINE, a non-systematic review was performed including articles between January 2000 and February 2016. English language original articles, reviews and editorials were selected based on their clinical relevance.
UTUC accounts for 5-10 % of all urothelial cancers, with an increasing incidence. UTUC and bladder cancer share some common risk factors, even if they are two different entities regarding practical, biological and clinical characteristics. Aristolochic acid plays an important role in UTUC pathogenesis in certain regions. It is further estimated that approximately 10 % of UTUC are part of the hereditary non-polyposis colorectal cancer spectrum disease. UTUC diagnosis remains mainly based on imaging and endoscopy, but development of new technologies is rapidly changing the diagnosis algorithm. To help the decision-making process regarding surgical treatment, extent of lymphadenectomy and selection of neoadjuvant systemic therapies, predictive tools based on preoperative patient and tumor characteristics have been developed.
Awareness regarding epidemiology, diagnosis, preoperative evaluation and prognostic assessment changes is essential to correctly diagnose and manage UTUC patients, thereby potentially improving their outcomes.
上尿路尿路上皮癌（UTUC）是一种相对罕见的疾病，关于特定主题的现有证据有限。本文的目的是回顾以往文献，总结目前关于UTUC流行病学、诊断、术前评估和预后评估的知识。
利用MEDLINE进行非系统性综述，纳入2000年1月至2016年2月间的文章。根据临床相关性选择英文原创文章、综述和社论。
UTUC占所有尿路上皮癌的5%-10%，发病率呈上升趋势。UTUC和膀胱癌有一些共同的危险因素，尽管它们在实际、生物学和临床特征方面是两种不同的疾病。马兜铃酸在某些地区的UTUC发病机制中起重要作用。进一步估计，约10%的UTUC是遗传性非息肉病性结直肠癌谱系疾病的一部分。UTUC的诊断仍主要基于影像学和内镜检查，但新技术的发展正在迅速改变诊断算法。为帮助进行手术治疗、淋巴结清扫范围和新辅助全身治疗选择的决策过程，已开发了基于术前患者和肿瘤特征的预测工具。
了解流行病学、诊断、术前评估和预后评估的变化对于正确诊断和管理UTUC患者至关重要，从而有可能改善其治疗效果。
