Leow Jeffrey J, Chong Kian Tai, Chang Steven L, Bellmunt Joaquim
Department of Urology, Tan Tock Seng Hospital,; Division of Urology and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School,.
Department of Urology, Tan Tock Seng Hospital.
ESMO Open. 2017 Jan 24;1(6):e000126. doi: 10.1136/esmoopen-2016-000126. eCollection 2016.
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.
上尿路尿路上皮癌（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是一种与UCB不同的疾病实体。这可能解释了为什么UTUC的自然病程与UCB不同，UTUC诊断时>60%出现浸润，而UCB只有15%-25%。因此，UTUC的管理在多种方面与UCB不同，包括手术管理、术后灌注治疗、术后监测和药物管理（新辅助和辅助化疗）。这篇综述旨在强调这些差异，重点是UTUC的独特管理以及最新进展。
