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abstract:
Epidemiology, diagnosis, preoperative evaluation and prognostic assessment of upper-tract urothelial carcinoma (UTUC)
#lynchsyndrome
Purpose
Upper-tract
urothelial carcinoma (UTUC) is a relatively uncommon disease with
limited available evidence on specific topics. The purpose of this
article was to review the previous literature to summarize the current
knowledge about UTUC epidemiology, diagnosis, preoperative evaluation
and prognostic assessment.
Methods
Using MEDLINE, a non-systematic review was performed
including articles between January 2000 and February 2016. English
language original articles, reviews and editorials were selected based
on their clinical relevance.
Results
UTUC accounts for
5–10 % of all urothelial cancers, with an increasing incidence. UTUC and
bladder cancer share some common risk factors, even if they are two
different entities regarding practical, biological and clinical
characteristics. Aristolochic acid (birthwort plant) plays an important role in UTUC
pathogenesis in certain regions. It is further estimated that
approximately 10 % of UTUC are part of the hereditary non-polyposis
colorectal cancer spectrum disease. UTUC diagnosis remains mainly based
on imaging and endoscopy, but development of new technologies is rapidly
changing the diagnosis algorithm. To help the decision-making process
regarding surgical treatment, extent of lymphadenectomy and selection of
neoadjuvant systemic therapies, predictive tools based on preoperative
patient and tumor characteristics have been developed.
Conclusions
Awareness regarding
epidemiology, diagnosis, preoperative evaluation and prognostic
assessment changes is essential to correctly diagnose and manage UTUC
patients, thereby potentially improving their outcomes.
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