Giudici Nicola, Bonne Fieke, Blarer Jennifer, Minoli Martina, Krentel Friedemann, Seiler Roland
Department of Urology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Department of Urology, Hospital Center Biel/Bienne, Biel/Bienne, Switzerland.
Transl Androl Urol. 2021 Oct;10(10):4036-4050. doi: 10.21037/tau-20-1472.
Urothelial carcinomas (UC) arise from the urothelium that covers the proximal urethra, urinary bladder, and the upper urinary tract. In daily routine and clinical trials UC originating from different locations are often treated and investigated in the same manner. However, differences between the two locations seem to be apparent and may question in handling them as a single oncologic entity. In this review we discuss similarities and differences between bladder and upper urinary tract UC and consider their potential impact on treatment strategies. Despite similarities of UC in the bladder (BC) and the upper urinary tract (UTUC), clinicopathologic and molecular differences may question to generally assemble both as a single tumor entity. Treatment standards for UTUC are often adopted from BC. However, a specific investigation in the former may still be meaningful as shown by the example of adjuvant cisplatin based chemotherapy. In conclusion, future investigations should prioritize the understanding of the tumor biology of both BC and UTUC. This may reveal which UTUC can be treated according to treatment standards of BC and in which cases, a separate approach may be more appropriate.
尿路上皮癌（UC）起源于覆盖近端尿道、膀胱和上尿路的尿路上皮。在日常临床实践和临床试验中，源自不同部位的UC通常以相同方式进行治疗和研究。然而，这两个部位之间的差异似乎很明显，可能会让人质疑将它们作为单一肿瘤实体来处理是否合适。在本综述中，我们讨论膀胱UC和上尿路UC之间的异同，并考虑它们对治疗策略的潜在影响。尽管膀胱UC（BC）和上尿路UC（UTUC）存在相似之处，但临床病理和分子差异可能会让人质疑是否应将两者一概视为单一肿瘤实体。UTUC的治疗标准通常借鉴BC。然而，以前者为例，基于顺铂的辅助化疗表明，对UTUC进行专门研究可能仍有意义。总之，未来的研究应优先致力于了解BC和UTUC的肿瘤生物学。这可能会揭示哪些UTUC可以根据BC的治疗标准进行治疗，以及在哪些情况下，采用单独的治疗方法可能更合适。
