Materiały źródłowe

• #1 Epidemiology, clinical presentation, and evaluation of upper-tract urothelial carcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7475674/

  An overview of epidemiological pattern of upper tract urothelial carcinoma (UTUC), including outcome of UTUC over past decades as well as factors responsible for observed epidemiological changes was performed. Gender and racial disparities influencing incidence of UTUC were reviewed. The incidence of multifocal urothelial carcinoma and relation of UTUC to urothelial carcinoma of bladder were examined. […] UTUC is still relatively an uncommon type of genitourinary malignancy representing 5% of urothelial cancers and less than 10% of renal tumors. It is difficult to determine the exact incidence of UTUC because often renal pelvis and ureteral malignancies are reported combined with renal cell carcinoma in a single category as renal tumors. […] The estimated annual incidence of UTUC in the Western countries is up to 2 new cases per 100,000 person-years. Urothelial pelvicalyceal tumors are diagnosed as twice as urothelial carcinoma of the ureter. The epidemiological patterns of UTUC over a period of 30 years was analyzed using a large population-based cohort from Surveillance, Epidemiology, and End Results (SEER) in the United States.

• #1 Global burden, risk factors, and temporal trends of ureteral cancer: a comprehensive analysis of cancer registries | BMC Medicine | Full Text

  https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-024-03485-x

  Ureteral cancer is a rare cancer. This study aimed to provide an up-to-date and comprehensive analysis on the global trends of ureteral cancer incidence and its association with lifestyle and metabolic risk factors. The incidence of ureteral cancer was estimated from the Cancer Incidence in Five Continents Plus and Global Cancer Observatory databases. The global age-standardized rate of ureteral cancer incidence in 2022 was 22.3 per 10,000,000 people. Regions with higher human development index (HDI), such as Europe, Northern America, and East Asia, were found to have a higher incidence of ureteral cancer. Higher HDI and gross domestic product (GDP) and a higher prevalence of smoking, alcohol drinking, physical inactivity, unhealthy dietary, obesity, hypertension, diabetes, and lipid disorder were associated with higher incidence of ureteral cancer. An overall increasing trend of ureteral cancer incidence was observed for the past decade, especially among the female population. Although ureteral cancer was relatively rare, the number of cases reported was rising over the world. The rising trends among females were more evident compared with the other subgroups, especially in European countries. Ureteral cancer is an uncommon disease. The incidence rate increased from 0.69 to 0.91 per 100,000 over the past 30 years in the US. Ureteral cancer is closely connected with bladder cancer, and they could occur synchronously or metachronously. Ureteral cancer is a disease of the elderly. It was found that the mean age at the time of diagnosis increased from 68 to 73 years old in past 30 years. Other risk factors include male gender, smoking, chemical exposure, and some region-specific factors, such as the consumption of aristolochic acid in Eastern Asia. This study aims to fill the research gap by conducting a more comprehensive analysis from a global perspective. The incidence of ureteral cancer in 185 countries in 2022 was estimated from the Global Cancer Observatory (GLOBOCAN) database. The Global Burden of Disease (GBD) database was used to extract country-specific data for risk factor analysis, including the prevalence of smoking, alcohol consumption, unhealthy eating, physical inactivity, obesity, hypertension, diabetes, and lipid disorders. Overall, the following risk factors were associated with higher ureteral cancer incidence: higher HDI, GDP per capita, higher prevalence of smoking, alcohol drinking, unhealthy dietary, physical inactivity, obesity, hypertension, diabetes, and lipid disorder. The overall trend of ureteral cancer was increasing; the significant rises were found in countries in different regions. Female was reported to have the most significant rising trend, while the greatest rise was generally found in European countries.

• #1 Ureteral cancer – Wikipedia

  https://en.wikipedia.org/wiki/Ureteral_cancer

  Between 1988 and 2001 in the United States, cancer surveillance reports to the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute included 1,333 cases of ureteral cancer in adults: 808 male and 525 female, 1,158 white and 42 black. „Five-year relative survival rates from cancers of the ureter were similar among males vs. females…” Of the total, 1,251 (94%) were transitional cell carcinoma of the papillary type. It has been determined that transitional cell carcinoma is twice as common in Caucasian men when compared to African-American men. As mentioned by the National Cancer Institute, most cases of ureter cancer occur in the US, Canada, Northern Europe, Australia, and New Zealand. Less common areas for ureter cancer diagnosis are Thailand, China, and the Philippines.

• #1 Epidemiology, clinical presentation, and evaluation of upper-tract urothelial carcinoma – Petros – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/33224/html

  UTUC is defined as malignant changes to the urothelial cells lining the urinary tract anywhere from renal calyces, renal pelvis, or ureter down to ureteral orifice. […] Although 61,700 estimated new cases of bladder cancer are diagnosed in 2019 in the United States, UTUC is still relatively an uncommon type of genitourinary malignancy representing 5% of urothelial cancers and less than 10% of renal tumors. […] The estimated annual incidence of UTUC in the Western countries is up to 2 new cases per 100,000 person-years. […] The epidemiological patterns of UTUC over a period of 30 years was analyzed using a large population-based cohort from Surveillance, Epidemiology, and End Results (SEER) in the United States. […] Raman et al. showed a minimal decrease in incidence of renal pelvicalyceal tumors from 1.19 to 1.15 cases per 100,000 person-years compared to an increase in incidence of ureteral tumors from 0.69 to 0.91 cases per 100,000 person-years accounting for an increase in overall incidence of UTUC from 1.88 to 2.06 cases per 100,000 person-years.

• #1

  https://link.springer.com/article/10.1007/s00345-022-04219-5

  To report contemporary epidemiological data and treatment trends for upper tract urothelial carcinoma (UTUC) in Germany over a 14-year period. […] The incidence of UTUC in Germany increased steadily with estimated case numbers of 2089 in 2006 and 2693 cases in 2018 (p0.03 for trend analysis). […] Overall, 13% of patients presented with lymph node metastasis and 7.6% of patients presented with distant metastasis at primary diagnosis. […] The 5-year overall survival (OS) was estimated to be 45% and the 10-year OS was 32%. […] The number of radical nephroureterectomies (RNU) for UTUC steadily increased from 1643 cases in 2006 to 2238 cases in 2019 (p0.005) with a shift from open surgery towards minimally invasive surgery. […] Diagnostic and therapeutic procedures for UTUC have increased and minimally invasive nephroureterectomy is the predominant approach concerning radical surgery in 2019. […] We present comprehensive data on the incidence, survival and surgical treatment modalities concerning UTUC in Germany. […] In the present study, we observed a significant increase in surgical therapies for UTUC while the ASR did not significantly increase over the study period.

• #1 Trend of the Incidence Rate of Kidney and Ureter Cancer in Iran from 2004 to 2016

  https://brieflands.com/articles/ijcm-140329

  Kidney and ureter cancers are two of the most prevalent urological cancers among Iranians. However, studies on the epidemiology and incidence of these cancers are primarily regional and focus on a specific period. […] The present study investigated the trend of the incidence rate of kidney and ureter cancer in Iran from 2004 to 2016. […] During the study period, 19 659 incidences of ureter and kidney cancer occurred in Iran. The crude and ASR of kidney cancer increased from 0.98 and 1.33 per 100 000 population in 2004 to 3.1 and 3.5 per 100 000 population in 2016, respectively. In addition, the crude and ASR of ureter cancer increased from 0.04 and 0.05 per 100 000 population in 2004 to 0.9 and 1.1 per 100 000 population in 2016, respectively. […] According to the results of this study, the incidence rate of kidney and ureter cancer increased over 13 years in Iran. Hence, the implementation of epidemiological studies in various regions and provinces is crucial for gaining a comprehensive and precise understanding of the underlying causes of kidney and ureter cancer incidence.

• #1 EAU Guidelines on Upper Urinary Tract Urothelial Cell Carcinoma – Uroweb

  https://uroweb.org/guidelines/upper-urinary-tract-urothelial-cell-carcinoma/chapter/epidemiology-aetiology-and-pathology

  Urothelial carcinoma (UC) is the second most common urological malignancy in developed countries. They can be localised in the lower (bladder and urethra) and/or the upper (pyelocaliceal cavities and ureter) urinary tract. Bladder cancer (BC) accounts for 90-95% of UCs whilst upper tract urothelial carcinomas (UTUC) account for only 5-10% of UCs with an estimated annual incidence in Western countries of almost two cases per 100,000 inhabitants. This rate has risen in the past few decades likely as a result of improved detection and the aging population. […] The peak incidence is in individuals aged 70-90 years and UTUC is twice as common in men. A retrospective international registry including data from 2,380 patients diagnosed between 2014 and 2019 (101 centres from 29 countries) confirmed that UTUC patients were predominantly male (70.5%) and 53.3% were former or current smokers. The majority of patients (53%) were diagnosed after they presented with symptoms, mainly visible haematuria. This was confirmed by a meta-analysis pooling 44 studies that showed a pooled UTUC incidence rate of 0.75% in patients with visible haematuria and 0.17% for those with non-visible haematuria. In addition, approximately two-thirds of patients who present with UTUCs have muscle-invasive disease at diagnosis compared to 15-25% of patients diagnosed with de novo BC. The higher incidence of muscle-invasive disease in UTUC vs. BC has been confirmed in population-based studies from Germany and England suggesting that muscle-invasive UTUC represents approximately half of incident cases in recent years. Approximately 9% of patients present with metastases.

• #1 Epidemiology, clinical presentation, and evaluation of upper-tract urothelial carcinoma – Petros – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/33224/html

  UTUC have a peak incidence between ages 70-90 years. […] The mean age at diagnosis has increased over the past 30 years with an overall increase of 5 years from 68 to 73 years. […] The outcome of UTUC is closely associated with the stage of disease at presentation. […] At time of diagnosis, approximately 40-50% of patients have non-muscle invasive UTUC (pTa/T1), 50-60% of patients present with muscle-invasive or non-organ confined disease (PT2), and up to 25% of patients presents with metastasis at diagnosis. […] Over a 30-year period, the incidence of in situ tumors have increased from 7.2% to 31%, compared to significant reduction in incidence of local tumors over the same period (50.4% to 23.4%, P<0.001). [...] There have been multiple factors influenced the incidence of UTUC and observed changes in epidemiological patterns of the disease over the past decades.

• #1 EAU Guidelines on Primary Urethral Carcinoma – Uroweb

  https://uroweb.org/guidelines/primary-urethral-carcinoma/chapter/epidemiology-aetiology-and-pathology

  Primary urethral carcinoma is considered a rare cancer, accounting for 1% of all genitourinary malignancies. In 2013, the prevalence of urethral carcinoma in the 28 European Union countries was 3,986 cases with an estimated annual incidence of 1,504 new cases, with a male/female prevalence of 2.9:1. Likewise, in an updated analysis of the Surveillance, Epidemiology and End Results (SEER) database (20042016), the incidence of primary urethral carcinoma peaked in the 75 years age group (7.6/million). The age-standardised rate was 4.3/million in men and 1.5/million in women and was almost negligible in those aged 55 years (0.2/million). After matching for tumour and patient characteristics, women present with higher disease stage and exhibited higher cancer-specific mortality (CSM). […] Both the Surveillance of Rare Cancers in Europe (RARECARE) project and SEER database have reported that urothelial carcinoma (UC) of the urethra is the predominant histological type of primary urethral cancer (5465%), followed by squamous cell carcinoma (SCC) (1622%) and AC (1016%). A SEER analysis of 2,065 men with primary urethral carcinoma (mean age 73 years) found that UC was most common (78%), and SCC (12%) and AC (5%) were significantly less frequent. In women, AC is the more frequent histology (3846.7%) followed by SCC (25.428%), UC (24.928%) and other histological entities (6%). Primary UC with unconventional histological subtypes is very rare and has a poor prognosis. An analysis of the SEER database from 2004 to 2016 identified 165 cases of Primary UC with unconventional histological subtypes, 70.3% of which were in women, and reported that Mullerian-type tumour is the most frequent unconventional histology of urethral cancer, followed by melanocytic-type histology.

• #1 Urothelial Tumors of the Renal Pelvis and Ureters: Practice Essentials, Epidemiology, Etiology

  https://emedicine.medscape.com/article/452449-overview

  Upper tract urothelial tumors are more common in men, with a male-to-female ratio of 3:1. Upper tract urothelial tumors are twice as common in white people as in people of African descent. […] Unlike bladder cancer, in which 80% of tumors are noninvasive, only 40% of upper tract tumors are noninvasive. […] Approximately 30-75% of patients with UTUC develop bladder tumors at some point during their cancer course. The risk of UTUC in patients with a bladder malignancy is 2-4%, but as high as 21-25% in patients with carcinoma in situ. Thus, higher grade seems to increase the risk of upper tract disease. […] Chen GL, El-Gabry EA, Bagley DH. Surveillance of upper urinary tract transitional cell carcinoma: the role of ureteroscopy, retrograde pyelography, cytology and urinalysis. J Urol. 2000 Dec. 164 (6):1901-4. […] Siemens DR, Morales A, Johnston B, Emerson L. A comparative analysis of rapid urine tests for the diagnosis of upper urinary tract malignancy. Can J Urol. 2003 Feb. 10 (1):1754-8.

• #1 Contemporary management of upper tract urothelial cell carcinoma

  https://www.wjgnet.com/2219-2816/full/v6/i1/1.htm

  Men are twice as likely to have UTUCC, compared to women. […] Although low in incidence, UTUCC is very aggressive, as many patients are asymptomatic and tend to present later with advanced stage disease, often with metastasis. […] A thorough understanding of this disease is pivotal in successful diagnosis and treatment. […] The most well known risk factor for UTUCC is aristolochic acid plants, more commonly used in Balkan regions and in Asian countries, especially in Taiwan. […] Balkan endemic nephropathy, associated with ingesting the aristolochic acid plants, can lead to renal failure and increased risk of UTUCC. […] Other risk factors for UTUCC are similar to bladder urothelial cell carcinoma, with the most common risk factor being cigarette smoking. […] Tobacco use is found to increase the relative risk exposure from 2.5 to 7.

• #1 Risks for renal pelvis and ureter cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/renal-pelvis-and-ureter/risks

  Smoking tobacco is the main risk for renal pelvis or ureter cancer. […] Cancer of the renal pelvis or ureter affects more men than women. It is more common in people older than 65 years of age. […] The following can increase your risk for renal pelvis or ureter cancer. […] People who have a lot of kidney stones or kidney infections have a higher risk of developing squamous cell carcinoma, which is usually rare, in the renal pelvis or ureter. […] Lynch syndrome is also called hereditary non-polyposis colorectal cancer (HNPCC). […] People who received radiation therapy to the abdomen or pelvis have a higher risk for renal pelvis or ureter cancer.

• #1 EAU Guidelines on Upper Urinary Tract Urothelial Cell Carcinoma – Uroweb

  https://uroweb.org/guidelines/upper-urinary-tract-urothelial-cell-carcinoma/chapter/epidemiology-aetiology-and-pathology

  Pyelocaliceal tumours are approximately twice as common as ureteral tumours and multifocal tumours are found in approximately 10-20% of cases. The presence of concomitant carcinoma in situ of the upper tract is between 11% and 36%. Concurrent BC is present in 17% of UTUC cases whilst a prior history of BC is found in 41% of American men but in only 4% of Chinese men. In high-risk NMIBC patients treated with intravesical bacillus Calmette-Gurin (BCG) the prevalence of UTUC ranged from 7.5% to 25% and from 3% to 5% in those with MIBC treated with radical cystectomy. […] Following treatment for UTUC, recurrence in the bladder occurs in 29% of UTUC patients, depending on patient-, tumour- and treatment-specific characteristics compared to a 25% recurrence rate in the contralateral upper tract. Upper tract UC and BC exhibit significant differences in the prevalence of common genomic alterations. In individual patients with a history of both tumours, BC and UTUC are often clonally related. Genomic characterisation of UTUC provides information regarding the risk of bladder recurrence and can identify tumours associated with Lynch syndrome.

• #1 Urothelial and Kidney Cancers

  https://www.cancernetwork.com/view/urothelial-and-kidney-cancers

  Occupational exposure to toxins has been associated with an increased risk of urothelial cancers. […] An increased risk of cancer of the renal pelvis and ureters occurs in patients with Balkan nephropathy. […] There are reports of families (eg, those with Lynch syndrome) with a higher risk of urothelial carcinoma of the urothelium, but the genetic basis for this familial clustering remains undefined. […] Blood in the urine is the most common symptom in patients presenting with urothelial tract cancer. […] Urinary voiding symptoms of urgency, frequency, and/or dysuria are also seen in patients with cancers of the bladder or ureters but are uncommon in patients with cancers of the renal pelvis. […] The initial evaluation of a patient in whom urothelial cancer is suspected consists of excretory urography (computed tomography [CT], magnetic resonance imaging [MRI], or intravenous pyelogram) followed by cystoscopy.

• #1 Ureteral Cancer and Ureteral Urothelial Carcinoma | Saint John’s Cancer Institute – Santa Monica, CA

  https://www.saintjohnscancer.org/urology/conditions/ureteral-cancer/

  Upper tract urothelial carcinoma is a cancer that can occur anywhere from the inner linings of the kidney, down the ureter, in the bladder, and down the urethra. […] Between 5% and 10% of all urothelial cancers start in the ureter (or renal pelvis) and are diagnosed as upper tract urothelial carcinoma (UTUC). […] Ureteral cancer is uncommon and occurs mostly in older adults and in those who previously treated for bladder cancer. […] Ureteral cancer is closely related to bladder cancer. These are cancers that originate in the renal pelvis, calyx, or ureters that extend to the bladder and are referred to as descending tumors. 22-47% of the ureteral cancer cases will also develop bladder cancer at some time in the future. […] 20-25% of patients with carcinoma in the bladder will develop upper tract urothelial carcinoma.

• #1 Upper Tract Urothelial Carcinoma: A Narrative Review of Current Surveillance Strategies for Non-Metastatic Disease

  https://www.mdpi.com/2072-6694/16/1/44

  The specific follow-up protocol for UTUC is generally determined based on the risk stratification group and the type of definitive therapy performed (i.e., KSS or RNU). […] Leading urological and oncological associations such as the NCCN, AUA, and EAU propose surveillance protocols for both KSS- and RNU-treated patients. These protocols typically encompass a combination of regular cystoscopy, cytology, and imaging. […] In general, evidence shows that patients with asymptomatically detected recurrence have better overall survival, CSS, and recurrence-free survival than symptomatic UTUC patients. […] Since bladder recurrence is common after definitive treatment for UTUC, cystoscopy is an integral part of the follow-up. […] The risk of bladder recurrence was assessed by two studies that created a nomogram to predict bladder recurrence at different time points.

• #1 Upper Tract Urothelial Carcinoma: A Narrative Review of Current Surveillance Strategies for Non-Metastatic Disease

  https://www.mdpi.com/2072-6694/16/1/44

  Unlike intravesical recurrences, which can be effectively monitored through frequent cystoscopies, the emergence of loco-regional and distant recurrences necessitates regular abdominopelvic and chest imaging. […] Risk stratification plays a crucial role in striking the right equilibrium between the intensity and frequency of surveillance modalities tailored for each patient. […] The key questions are the optimal protocol and the duration of surveillance. […] In conclusion, considering their elevated risk of recurrence, patients with UTUC post RNU necessitate a meticulous follow-up regimen. This should encompass routine chest and abdominopelvic imaging, supplemented with periodic cystoscopy. It is particularly crucial to maintain an intensified monitoring schedule during the initial two years of surveillance.

• #1

  https://www.cancervic.org.au/cancer-information/types-of-cancer/upper_tract_urothelial/utuc_overview.html

  Around 470 Australians are diagnosed each year with UTUC. It is three times more likely to be diagnosed in men than women, and in people aged over 70 years. […] Most upper tract urothelial cancers will need follow-up cystoscopies and/or ureteroscopies, imaging and urine tests annually. […] Once your treatment has finished, you will have regular check-ups to confirm that the cancer hasn’t come back. Ongoing surveillance for UTUC involves a schedule of tests, scans, scopes and physical examinations.

• #1 Renal Pelvic and Ureteral Cancers – Genitourinary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/genitourinary-disorders/genitourinary-cancers/renal-pelvic-and-ureteral-cancers

  Cancers of the renal pelvis and ureters are usually urothelial carcinoma and occasionally squamous cell carcinomas. Urothelial carcinoma of the renal pelvis accounts for about 7 to 15% of all kidney tumors. Urothelial carcinoma of the ureters accounts for about 4% of upper tract tumors (1). Risk factors are the same as those for bladder cancer (smoking, excess phenacetin use, long-term cyclophosphamide use, chronic irritation, exposure to certain chemicals). Inhabitants of the Balkans with endemic familial nephropathy are inexplicably predisposed to develop upper tract urothelial carcinoma. Genetically, urothelial carcinomas of the upper tract have been linked to Lynch syndrome and may be the presenting cancer. […] Periodic surveillance cystoscopy is indicated because renal pelvic and ureteral cancers tend to recur in the bladder, and such recurrence, if detected at an early stage, may be treated by fulguration, transurethral resection, or intravesical instillations.

• #1 Prognostic factors and outcomes of primary transitional cell carcinoma of the ureter: a population-based study | Oncotarget

  https://www.oncotarget.com/article/19623/

  Objective: This study investigated the prognostic factors and outcomes of a large observational cohort of patients with primary transitional cell carcinoma of the ureter, which was obtained from the Surveillance, Epidemiology, and End Results database. […] We used the Surveillance, Epidemiology, and End Results program to identify 1910 patients who had available clinical and follow-up information and were diagnosed for primary transitional cell carcinoma of the ureter between 2004 and 2013. Descriptive statistics were used to explore the epidemiology, treatment practices, and tumor characteristics of the patients. […] Multivariate analysis identified tumor grade, tumor size, AJCC stage, M stage, cancer-directed surgical procedure and radiation as independent factors of primary transitional cell carcinoma of the ureter. […] Durable cancer control can be expected in patients treated with surgery for early stage UTUC. The presence of advanced stage disease exerts a profound detrimental effect on the survival of patients.

• #1 Survival statistics for cancer of the renal pelvis or ureter | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/renal-pelvis-and-ureter/prognosis-and-survival/survival-statistics

  Survival statistics for cancer of the renal pelvis or ureter are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular persons chances of survival. […] In Canada, the 5-year net survival for cancer of the ureter is 46%. This means that about 46% of people diagnosed with cancer of the ureter will survive at least 5 years. […] Survival rates for cancer of the ureter are about 10% to 20% lower than for a similar grade and stage of cancer in the renal pelvis.

• #1 Prognostic factors and outcomes of primary transitional cell carcinoma of the ureter: a population-based study | Oncotarget

  https://www.oncotarget.com/article/19623/text/

  Objective: This study investigated the prognostic factors and outcomes of a large observational cohort of patients with primary transitional cell carcinoma of the ureter, which was obtained from the Surveillance, Epidemiology, and End Results database. […] We used the Surveillance, Epidemiology, and End Results program to identify 1910 patients who had available clinical and follow-up information and were diagnosed for primary transitional cell carcinoma of the ureter between 2004 and 2013. Descriptive statistics were used to explore the epidemiology, treatment practices, and tumor characteristics of the patients. […] The median overall survival (OS) was 46 months, and the 5-year OS rate was 41.8%. The median CSS was 78 months, and the 5-year CSS rate was 54.3%. […] Multivariate analysis identified tumor grade, tumor size, AJCC stage, M stage, cancer-directed surgical procedure and radiation as independent factors of primary transitional cell carcinoma of the ureter.

• #1 Prognostic factors and outcomes of primary transitional cell carcinoma of the ureter: a population-based study | Oncotarget

  https://www.oncotarget.com/article/19623/text/

  For early stage patients, the surgical procedure was associated with fairly longer survival and additional radiation may cause more harm than benefit. […] Meanwhile, for advanced stage patients, the impact of surgery on OS and CSS greatly decreased. Radiation exerted a very limited impact on clinical outcomes. […] Patients with bad tumor differentiation or a large tumor size were more likely to have advanced stage disease. […] The presence of advanced stage disease exerts a profound detrimental effect on the survival of patients. […] The cancer-directed surgical procedure is considered to be the gold standard of treatment. […] However, biological and molecular differences do exist between the upper and lower urinary tracts. […] Our findings concerning primary transitional cell carcinoma of the ureter based on a new database have partially updated the former conclusion. Radiation is considered to be an independent prognostic factor in this study, in which it is associated with inferior survival.

• #1

  https://link.springer.com/article/10.1007/s00432-024-05684-8

  To date, there have been few studies examining the prognostic implications of histological subtypes in ureteral cancer. […] This study aimed to utilize the Surveillance, Epidemiology and End Results database to assess the impact of histological type on ureteral cancer prognostic outcomes and discovered how histological type and T-stage influence the efficacy of chemotherapy. […] Histological type affects the prognosis of ureteral cancer. And evaluation of cancer histological type and T stage in ureteral cancer patients prior to chemotherapy is mandatory. […] Among all the histological type of UC, patients with typical urothelial carcinoma exhibited superior CSS and OS compared to those with atypical UC. […] Chemotherapy yielded diverse effects across various histological types of UC. Statistically, chemotherapy demonstrated a positive impact on the prognosis of patients with non-papillary urothelial carcinoma, whereas its effect on patients with papillary urothelial carcinoma lacked statistical significance. […] Different T stages exhibited varying benefits from chemotherapy, with T3/T4 cases potentially benefiting more, while T1/T2 cases may not derive benefits from chemotherapy.

• #1 Study to assess performance of CxBladder test in urothelial carcinoma surveillance

  https://www.urologytimes.com/view/study-to-assess-performance-of-cxbladder-test-in-urothelial-carcinoma-surveillance

  The observational LOBSTER study has already enrolled 303 patients and collected 479 samples. […] The protocol for the observational LOBSTER study (NCT05080998), which is assessing the performance of the CxBladder Monitor and Monitor Plus tests in the surveillance for recurrence in patients with low-, intermediate-, and high-risk urothelial carcinoma, was shared during a presentation at the 100th annual meeting for the Western Section of the American Urological Association (WSAUA) in Kauai, Hawaii. […] Patients are eligible for enrollment in the study if they are under surveillance for nonmuscle-invasive bladder cancer (NMIBC); have low-, intermediate-, or high-risk disease based on American Urological Association (AUA)/Society of Urologic Oncology guidelines; experienced previous recurrence of urothelial carcinoma; and are able to provide a voided urine sample.

• #1 Study to assess performance of CxBladder test in urothelial carcinoma surveillance

  https://www.urologytimes.com/view/study-to-assess-performance-of-cxbladder-test-in-urothelial-carcinoma-surveillance

  According to the investigators, Primary tumor tissue will also be collected when available for genotyping using DNA markers to assess UC risk. […] The primary end points for the study include sensitivity, specificity, negative predictive value, positive predictive value, and test-negative rate of the CxBladder tests. […] According to the company, goals of the trial include demonstrating that it is safe to alternate CxBladder with cystoscopy for patients under surveillance for recurrence of urothelial carcinoma as well as providing support for the inclusion of biomarkers as an alternative to cystoscopy in this setting in the AUA/National Comprehensive Cancer Network guidelines.

• #1 Surveillance Bias in Cancer Risk After Unrelated Medical Conditions: Example Urolithiasis | Scientific Reports

  https://www.nature.com/articles/s41598-017-08839-5

  We analysed cancer risks in patients with urinary tract stones but some features of the generated results alarmed us about possible surveillance bias, which we describe in this report. […] The early aim of the present study was to assess the risk for urological cancers in patients who had previously been diagnosed with UL. […] UL is thought to be associated with the risk of kidney and bladder cancers, and a study from Taiwans National Health Insurance Research Database reported that UL is associated with a high risk of many systemic cancers in addition to urinary tract cancers. […] Based on the results in Table 1 a noncritical interpretation would point out that UL is associated with cancer at multiple sites, even though the affected organs appeared to convey the highest risk. […] The follow-up results in Table 2 exposed the concerns about surveillance bias, which may to be due to incidental clinical findings by computed tomography in diagnosis of kidney, ureter and mixed stones.

• #1 Surveillance Bias in Cancer Risk After Unrelated Medical Conditions: Example Urolithiasis | Scientific Reports

  https://www.nature.com/articles/s41598-017-08839-5

  The more frequent in situ diagnoses and smaller tumour sizes in UL patients compared to all cancer patients supported the existent of surveillance bias although the differences were modest. […] Although the above data suggest involvement of surveillance bias, we need to admit that we have not eliminated alternative mechanisms which predispose to UL and which might jointly predispose to cancer. […] We conclude that quantification of risks may be extremely difficult in situations when surveillance bias is likely, and scientists and readers of scientific texts should be aware of such problems in observational studies.

• #2 Epidemiology, clinical presentation, and evaluation of upper-tract urothelial carcinoma – Petros – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/33224/html

  UTUC is defined as malignant changes to the urothelial cells lining the urinary tract anywhere from renal calyces, renal pelvis, or ureter down to ureteral orifice. […] Although 61,700 estimated new cases of bladder cancer are diagnosed in 2019 in the United States, UTUC is still relatively an uncommon type of genitourinary malignancy representing 5% of urothelial cancers and less than 10% of renal tumors. […] The estimated annual incidence of UTUC in the Western countries is up to 2 new cases per 100,000 person-years. […] The epidemiological patterns of UTUC over a period of 30 years was analyzed using a large population-based cohort from Surveillance, Epidemiology, and End Results (SEER) in the United States. […] Raman et al. showed a minimal decrease in incidence of renal pelvicalyceal tumors from 1.19 to 1.15 cases per 100,000 person-years compared to an increase in incidence of ureteral tumors from 0.69 to 0.91 cases per 100,000 person-years accounting for an increase in overall incidence of UTUC from 1.88 to 2.06 cases per 100,000 person-years.

• #2 Urothelial Tumors of the Renal Pelvis and Ureters: Practice Essentials, Epidemiology, Etiology

  https://emedicine.medscape.com/article/452449-overview

  Upper tract urothelial tumors are more common in men, with a male-to-female ratio of 3:1. Upper tract urothelial tumors are twice as common in white people as in people of African descent. […] Unlike bladder cancer, in which 80% of tumors are noninvasive, only 40% of upper tract tumors are noninvasive. […] Approximately 30-75% of patients with UTUC develop bladder tumors at some point during their cancer course. The risk of UTUC in patients with a bladder malignancy is 2-4%, but as high as 21-25% in patients with carcinoma in situ. Thus, higher grade seems to increase the risk of upper tract disease. […] Chen GL, El-Gabry EA, Bagley DH. Surveillance of upper urinary tract transitional cell carcinoma: the role of ureteroscopy, retrograde pyelography, cytology and urinalysis. J Urol. 2000 Dec. 164 (6):1901-4. […] Siemens DR, Morales A, Johnston B, Emerson L. A comparative analysis of rapid urine tests for the diagnosis of upper urinary tract malignancy. Can J Urol. 2003 Feb. 10 (1):1754-8.

• #2 Urothelial Tumors of the Renal Pelvis and Ureters: Practice Essentials, Epidemiology, Etiology

  https://emedicine.medscape.com/article/452449-overview

  Urothelial tumors of the renal pelvis and ureters (upper urinary tract) are relatively rare. Tumors of the renal pelvis account for approximately 10% of all renal tumors and only 5% of all urothelial tumors of the urinary tract. Ureteral tumors occur about one half as often as tumors located in the renal pelvis. Urothelial carcinomas account for more than 95% of urothelial tumors of the upper urinary tract. […] The estimated annual incidence in Western countries is approximately two cases per 100,000 population. However, the incidence may be increasing: a population-based study in Norway reported an incidence of 4.7 per 100,000, representing 13% of all urothelial cancers from 2014-2018. […] The mean age in persons who develop upper urinary tract urothelial tumors is 65 years. The incidence of urothelial carcinoma increases with age. The peak incidence is in those in their 70s and 80s.

• #2 Risks for renal pelvis and ureter cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/renal-pelvis-and-ureter/risks

  Smoking tobacco is the main risk for renal pelvis or ureter cancer. […] Cancer of the renal pelvis or ureter affects more men than women. It is more common in people older than 65 years of age. […] The following can increase your risk for renal pelvis or ureter cancer. […] People who have a lot of kidney stones or kidney infections have a higher risk of developing squamous cell carcinoma, which is usually rare, in the renal pelvis or ureter. […] Lynch syndrome is also called hereditary non-polyposis colorectal cancer (HNPCC). […] People who received radiation therapy to the abdomen or pelvis have a higher risk for renal pelvis or ureter cancer.

• #2 Renal Pelvis / Ureteral Cancer | The Urology Group of Virginia

  https://www.urologygroupvirginia.com/urologic-cancer-center/kidney-cancer/renal-pelvis-ureteral-cancer

  Transitional cell carcinoma can occur in the renal pelvis, the ureter, or the urinary bladder. […] Cigarette smoking alone has been estimated to cause 50% of all transitional cell cancers. […] When there is a history of transitional cell carcinoma elsewhere, such as bladder cancer, there may be an increased risk of developing cancer of the renal pelvis or ureter. […] Follow up will be necessary for years to make sure cancer does not appear in transitional cells in the rest of the urinary system.

• #2 Ureteral cancer – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ureteral-cancer/symptoms-causes/syc-20360721

  Factors that can increase the risk of ureteral cancer include: Increasing age. The risk of ureteral cancer goes up with age. Most people diagnosed with this cancer are in their 70s and 80s. Previous bladder or kidney cancer. People who have been diagnosed with bladder cancer or kidney cancer have a higher risk of ureteral cancer. Smoking tobacco. Smoking tobacco raises the risk of ureteral cancer. It also raises the risk of other urinary tract cancers, including kidney cancer and bladder cancer. Exposure to certain chemicals. Working with certain chemicals is linked to an increased risk of ureteral cancer. Family history of cancer. If you have a strong family history of cancer, discuss it with your healthcare professional. Together you may decide whether to consider genetic testing for inherited cancer syndromes such as Lynch syndrome. Lynch syndrome raises the risk of colon cancer and other cancers, including ureteral cancer. […] Although there’s no sure way to prevent ureteral cancer, you can take steps to help reduce your risk.

• #2 Contemporary management of upper tract urothelial cell carcinoma

  https://www.wjgnet.com/2219-2816/full/v6/i1/1.htm

  Upper tract urothelial cell carcinoma (UTUCC), formerly known as transitional cell carcinoma of the upper urinary tract, is a rare oncologic disease in Western countries. […] Upper tract urothelial cell cancer can be found with higher incidence in Balkan regions, and most recently in certain Asian countries especially in Taiwan. […] Upper tract urothelial cell cancers are most commonly diagnosed later in life, mostly in the eighth decade. […] However, it should also be considered in younger populations, especially in patients with exposure to aristolochic acid (AA) plants, which is commonly used for weight loss in Asian countries. […] It is a very uncommon disease, with an incidence of less than 1 case per 40000. […] It makes up 5% of all urothelial tumors and 5% to 7% of all renal tumors.

• #2 Epidemiology, clinical presentation, and evaluation of upper-tract urothelial carcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7475674/

  The outcome of UTUC is closely associated with the stage of disease at presentation. At time of diagnosis, approximately 40-50% of patients have non-muscle invasive UTUC (pTa/T1), 50-60% of patients present with muscle-invasive or non-organ confined disease (PT2), and up to 25% of patients presents with metastasis at diagnosis. […] Over a 30-year period, the incidence of in situ tumors have increased from 7.2% to 31%, compared to significant reduction in incidence of local tumors over the same period (50.4% to 23.4%, P0.001). […] There have been multiple factors influenced the incidence of UTUC and observed changes in epidemiological patterns of the disease over the past decades.

• #2 Ureteral cancer

  http://medbox.iiab.me/kiwix/wikipedia_en_medicine_2019-12/A/Ureteral_cancer

  Between 1988 and 2001 in the United States, cancer surveillance reports to SEER included 1,333 cases of ureteral cancer in adults: 808 male and 525 female, 1,158 white and 42 black. Of the total, 1,251 (94%) were transitional cell carcinoma of the papillary type. […] „Five-year relative survival rates from cancers of the ureter were similar among males vs. females…”

• #2 Epidemiology, clinical presentation, and evaluation of upper-tract urothelial carcinoma – Petros – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/33224/html

  UTUC have a peak incidence between ages 70-90 years. […] The mean age at diagnosis has increased over the past 30 years with an overall increase of 5 years from 68 to 73 years. […] The outcome of UTUC is closely associated with the stage of disease at presentation. […] At time of diagnosis, approximately 40-50% of patients have non-muscle invasive UTUC (pTa/T1), 50-60% of patients present with muscle-invasive or non-organ confined disease (PT2), and up to 25% of patients presents with metastasis at diagnosis. […] Over a 30-year period, the incidence of in situ tumors have increased from 7.2% to 31%, compared to significant reduction in incidence of local tumors over the same period (50.4% to 23.4%, P<0.001). [...] There have been multiple factors influenced the incidence of UTUC and observed changes in epidemiological patterns of the disease over the past decades.

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