Journal article
Upper Urinary Tract Carcinoma In Situ: Current Knowledge, Future Direction.
- Redrow GP Department of Urology, University of Texas MD Anderson Cancer Center, Houston, Texas; Division of Urology, University of Texas at Houston School of Medicine, Houston, Texas.
- Guo CC Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, Texas.
- Brausi MA Ausl Modena, Nuovo Ospendale Civile-S. Agostino Estense, Modena, Italy.
- Coleman JA Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
- Fernandez MI Department of Urology, Clinica Alemana de Santiago, Santiago, Chile.
- Kassouf W Division of Urology, McGill University Health Center, Montreal, Quebec, Canada.
- Keeley FX Bristol Urological Institute, Southmead Hospital, Bristol, United Kingdom.
- Margulis V Department of Urology, U.T. Southwestern Medical Center, Dallas, Texas.
- Raman JD Division of Urology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.
- Roupret M Department of Urology, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique Hopitaux de Paris, Faculty of Medicine Pierre et Marie Curie, Institut Universitaire de Cancérologie GRC5, University Paris 6, Paris, France.
- Shariat SF Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna General Hospital, Vienna, Austria.
- Spiess PE Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, Florida.
- Thalmann GN Department of Urology, University of Bern, Inselspital, Bern, Switzerland.
- Matin SF Department of Urology, University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: surmatin@mdanderson.org.
- 2016-09-25
Published in:
- The Journal of urology. - 2017
BCG vaccine
carcinoma in situ
urinary bladder neoplasms
urologic neoplasms
Carcinoma in Situ
Humans
Neoplasm Recurrence, Local
Survival Rate
Urinary Tract
Urologic Neoplasms
English
PURPOSE
Carcinoma in situ of the urinary tract is a high grade form of nonmuscle invasive urothelial cancer. Our understanding of this entity in the upper tract is poor, and case management remains challenging due to knowledge gaps regarding the definition, diagnosis, treatment options and followup of the disease. We reviewed the available literature for similarities and differences between bladder and upper tract carcinoma in situ, and herein summarize the best available data.
MATERIALS AND METHODS
We reviewed PubMed® and MEDLINE™ databases from January 1976 through September 2014. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement was used to screen publications. All authors participated in the development of a consensus definition of disease.
RESULTS
A total of 61 publications were found suitable for this review. All studies were retrospective. Compared to bladder carcinoma in situ, upper tract carcinoma in situ appears to have lower progression rates and improved survival. All available studies demonstrate topical therapy to be effective in treating upper tract carcinoma in situ, with decreased recurrence rates compared to bladder carcinoma in situ. Highlighted areas of current knowledge gaps include variable definitions of disease, methods of drug delivery and ideal treatment course. Improving methods for detection may allow easier diagnosis and more effective treatment.
CONCLUSIONS
Based on the available data, organ preserving therapy with topical agents is an alternative to radical surgery in select patients with upper tract carcinoma in situ, although this method has not been evaluated in prospective trials. A paradigm shift regarding detection and treatment is needed to improve care and allow better renal preservation. A consensus definition of the disease is offered, and several areas of major knowledge gaps and opportunities for future research are identified.
Carcinoma in situ of the urinary tract is a high grade form of nonmuscle invasive urothelial cancer. Our understanding of this entity in the upper tract is poor, and case management remains challenging due to knowledge gaps regarding the definition, diagnosis, treatment options and followup of the disease. We reviewed the available literature for similarities and differences between bladder and upper tract carcinoma in situ, and herein summarize the best available data.
MATERIALS AND METHODS
We reviewed PubMed® and MEDLINE™ databases from January 1976 through September 2014. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement was used to screen publications. All authors participated in the development of a consensus definition of disease.
RESULTS
A total of 61 publications were found suitable for this review. All studies were retrospective. Compared to bladder carcinoma in situ, upper tract carcinoma in situ appears to have lower progression rates and improved survival. All available studies demonstrate topical therapy to be effective in treating upper tract carcinoma in situ, with decreased recurrence rates compared to bladder carcinoma in situ. Highlighted areas of current knowledge gaps include variable definitions of disease, methods of drug delivery and ideal treatment course. Improving methods for detection may allow easier diagnosis and more effective treatment.
CONCLUSIONS
Based on the available data, organ preserving therapy with topical agents is an alternative to radical surgery in select patients with upper tract carcinoma in situ, although this method has not been evaluated in prospective trials. A paradigm shift regarding detection and treatment is needed to improve care and allow better renal preservation. A consensus definition of the disease is offered, and several areas of major knowledge gaps and opportunities for future research are identified.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.juro.2016.03.194
- PMID 27664578
- Persistent URL
- https://sonar.ch/global/documents/49341
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