2016 European Assoc Urology: Upper Urinary Tract Urothelial Cell Carcinoma (note: Lynch syndrome) Ovarian Cancer and Us OVARIAN CANCER and US Ovarian Cancer and Us

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Saturday, September 24, 2016

2016 European Assoc Urology: Upper Urinary Tract Urothelial Cell Carcinoma (note: Lynch syndrome)




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2.3.Future goals

The results on ongoing and new systematic reviews will be included in the 2017 update of the UTUC Guidelines. These reviews are performed using standard Cochrane systematic review methodology; http://www.cochranelibrary.com/about/about-cochrane-systematic-reviews.html.
  

3.1.Epidemiology

Urothelial carcinomas (UCs) are the fifth most common tumours [4]. They can be located in the lower (bladder and urethra) or upper (pyelocaliceal cavities and ureter) urinary tract. Bladder tumours account for 90-95% of UCs and are the most common malignancy of the urinary tract [5]. In contrast, UTUCs are uncommon and account for only 5-10% of UCs [4,6]. Pyelocaliceal tumours are about twice as common as ureteral tumours. In 17% of cases, concurrent bladder cancer is present [7]. Recurrence in the bladder occurs in 22-47% of UTUC patients [8], compared with 2-6% in the contralateral upper tract [9,10].
Approximately 60% of UTUCs are invasive at diagnosis compared with 15-25% of bladder tumours [11,12]. UTUCs have a peak incidence in people aged 70-90 years and are three times more common in men [13,14].
Familial/hereditary UTUCs are linked to (Lynch syndrome) hereditary non-polyposis colorectal carcinoma (HNPCC) [15], which can be screened for during interview (Figure 3.1) [16]. Patients should undergo DNA sequencing to identify hereditary cancers misclassified as sporadic if they fulfil the criteria for HNPCC [15,17].

5.2.Diagnosis

5.2.1.Imaging

5.2.1.1.Computed tomography urography

Computed tomography urography (CTU) has the highest diagnostic accuracy for the diagnosis of UTUC [41]. The sensitivity of CTU for UTUC is 0.67-1.0 and the specificity is 0.93-0.99 [42-49].....

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