Rosenbaum Clemens M, Netsch Christopher, Filmar Simon, Hook Sophia, Gross Andreas J, Becker Benedikt
Klinik für Urologie, Asklepios Klinik Barmbek, Rübenkamp 220, 22307, Hamburg, Deutschland.
Klinik für Urologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.
Urologie. 2025 Feb;64(2):182-191. doi: 10.1007/s00120-024-02422-3. Epub 2024 Sep 13.
Urothelial carcinoma of the upper urinary tract is rare but the incidence is currently increasing in western countries. Radical nephroureterectomy has long been the standard treatment; however, it can lead to chronic kidney failure and also the necessity for dialysis. Therefore, organ-preserving treatment is now recommended for selected patients with low-risk tumors. The choice of treatment depends on the tumor characteristics, comorbidities and individual risk factors. Surgical options for organ preservation include ureterorenoscopy (URS), percutaneous treatment and partial ureteral resection. The URS is the most frequently used method for organ preservation. Photodynamic diagnostics (PDD) and narrow band imaging (NBI) can potentially also be used for tumor detection in the upper urinary tract. Conservative options such as topical treatment with mitomycin C or Bacillus Calmette-Guérin (BCG) and systemic treatment options are also possible.
上尿路尿路上皮癌较为罕见，但目前在西方国家其发病率正在上升。根治性肾输尿管切除术长期以来一直是标准治疗方法；然而，它可能导致慢性肾衰竭以及透析的必要性。因此，现在推荐对选定的低风险肿瘤患者进行保器官治疗。治疗方法的选择取决于肿瘤特征、合并症和个体风险因素。保器官的手术选择包括输尿管肾镜检查（URS）、经皮治疗和部分输尿管切除术。URS是最常用的保器官方法。光动力诊断（PDD）和窄带成像（NBI）也有可能用于上尿路肿瘤的检测。诸如丝裂霉素C或卡介苗（BCG）局部治疗等保守选择以及全身治疗选择也是可行的。
