Consultation on UTUC, Stockholm 2018 aspects of diagnosis of upper tract urothelial carcinoma

Autor: Grzegorz Fojecki, Guido Giusti, Anders Magnusson, Palle Jørn Sloth Osther, Georg Jaremko, Joyce Baard, Christian Seitz, Olivier Traxer, Thomas Knoll, Marianne Brehmer
Přispěvatelé: Uppsala University Hospital, CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU), University of Amsterdam [Amsterdam] (UvA), VU University Medical Center [Amsterdam], University of Southern Denmark (SDU), Karolinska University Hospital [Stockholm], Medizinische Universität Wien = Medical University of Vienna, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS San Raffaele Pisana), Karolinska Institutet [Stockholm], Graduate School, Urology, ACS - Atherosclerosis & ischemic syndromes, APH - Personalized Medicine, APH - Quality of Care, CCA - Imaging and biomarkers
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Nephrology
medicine.medical_specialty
Urology
Biopsy
030232 urology & nephrology
[SDV.CAN]Life Sciences [q-bio]/Cancer
Ct urography
[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology
UTUC
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
CT urography
Urologi och njurmedicin
Carcinoma
Ureteral Neoplasms/diagnosis
Ureteroscopy
Medicine
Humans
Diagnostic samples
Urology and Nephrology
Diagnostics
Kidney Neoplasms/diagnosis
Upper urinary tract
Urothelial carcinoma
Sweden
Carcinoma
Transitional Cell
medicine.diagnostic_test
business.industry
Ureteral Neoplasms
General surgery
Diagnostic Techniques
Urological
Carcinoma
Transitional Cell/diagnosis
medicine.disease
Topic Paper
Prognosis
Kidney Neoplasms
3. Good health
Upper tract
Upper tract urothelial carcinoma
030220 oncology & carcinogenesis
Practice Guidelines as Topic
business
Zdroj: World Journal of Urology
World Journal of Urology, Springer Verlag, 2019, 37 (11), pp.2271-2278. ⟨10.1007/s00345-019-02732-8⟩
World journal of urology, 37(11), 2271-2278. Springer Verlag
Fojecki, G, Magnusson, A, Traxer, O, Baard, J, Osther, P J S, Jaremko, G, Seitz, C, Knoll, T, Giusti, G & Brehmer, M 2019, ' Consultation on UTUC, Stockholm 2018 aspects of diagnosis of upper tract urothelial carcinoma ', World Journal of Urology, vol. 37, no. 11, pp. 2271-2278 . https://doi.org/10.1007/s00345-019-02732-8
ISSN: 0724-4983
1433-8726
DOI: 10.1007/s00345-019-02732-8⟩
Popis: PURPOSE: To summarize knowledge on upper urinary tract carcinoma (UTUC) regarding diagnostic procedures, risk factors and prognostic markers.METHODS: A scoping review approach was applied to search literature in Pubmed, Web of Science, and Embase. Consensus was reached through discussions at Consultation on UTUC in Stockholm, September 2018.RESULTS: Tumor stage and grade are the most important prognostic factors. CT urography (CTU) including corticomedullary phase is the preferred imaging modality. A clear tumor on CTU in combination with high-grade UTUC in urine cytology identifies high-risk UTUC, and in some cases indirect staging can be obtained. Bladder urine cytology has limited sensitivity, and in most cases ureterorenoscopy (URS) with in situ samples for cytology and histopathology are mandatory for exact diagnosis. Image-enhancing techniques, Image S1 and narrow-band imaging, may improve tumor detection at URS. Direct confocal laser endomicroscopy may help to define grade during URS. There is strong correlation between stage and grade, accordingly correct grading is crucial. The correlation is more pronounced using the 1999 WHO than the 2004 classification: however, the 1999 system risks greater interobserver variability. Using both systems is advisable. A number of tissue-based molecular markers have been studied. None has proven ready for use in clinical practice.CONCLUSIONS: Correct grading and staging of UTUC are mandatory for adequate treatment decisions. Optimal diagnostic workup should include CTU with corticomedullary phase, URS with in situ cytology and biopsies. Both WHO classification systems (1999 and 2004) should be used to decrease risk of undergrading or overtreatment.
Databáze: OpenAIRE
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