Materiały źródłowe

• #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. […] Ureteral cancer is uncommon and occurs mostly in older adults and in those who previously treated for bladder cancer. […] 20-25% of patients with carcinoma in the bladder will develop upper tract urothelial carcinoma. […] There are two types of treatment for upper tract urothelial carcinomas: […] Nephron sparing treatment, or conservative management treatment, means preservation of the entire kidney, or part of the kidney, while reducing the adverse effects to kidney function. […] Localized chemotherapy or immunotherapy in the pelvis or the ureter may also be appropriate for some cancers. […] A drug known as mitomycin-c has been effective for the treatment of urothelial cancers in the bladder and performing washes (instillations), which is placing the material into the bladder and having the patient hold it in for a short period of time before urinating.

• #2 Transitional Cell Cancer (Kidney/Ureter) Treatment – NCI

  https://www.cancer.gov/types/kidney/patient/transitional-cell-treatment-pdq

  Transitional cell cancer of the renal pelvis and ureter is a type of cancer that forms in the transitional cells of the renal pelvis and ureter. […] There are different types of treatment for patients with transitional cell cancer of the renal pelvis and ureter. […] The following type of treatment is used: Surgery. […] One of the following surgical procedures may be used to treat transitional cell cancer of the renal pelvis and ureter: Nephroureterectomy is surgery to remove the entire kidney, the ureter, and the bladder cuff (tissue that connects the ureter to the bladder). Most people with transitional cell cancer of the renal pelvis and ureter undergo nephroureterectomy. […] Segmental resection of the ureter is a surgical procedure to remove the part of the ureter that contains cancer and some of the healthy tissue around it. The ends of the ureter are then reattached. This treatment is used when the cancer is superficial and in the lower third of the ureter only, near the bladder.

• #3 Ureteral cancer | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/ureteral-cancer

  Ureteral cancer is closely related to bladder cancer. The cells that line the ureters are the same type of cells that line the inside of the bladder. People diagnosed with ureteral cancer have an increased risk of bladder cancer. So people with ureteral cancer are usually tested for signs of bladder cancer. […] Treatment for ureteral cancer typically involves surgery. In certain situations, chemotherapy, immunotherapy or targeted therapy may be recommended. […] Treatment options for ureteral cancer include surgery, chemotherapy, immunotherapy and targeted therapy. Treatment depends on many factors. These factors include the size and location of the cancer, how aggressive the cells are, and your own goals and preferences. […] Surgery is often recommended to remove ureteral cancer. The kind of surgery used for your ureteral cancer will depend on your cancer.

• #4 New – Low Grade Upper Tract (Ureter/ Renal Pelvis) Treatment „Jelmyto” – American Bladder Cancer Society

  https://bladdercancersupport.org/discussion/new-low-grade-upper-tract-ureter-renal-pelvis-treatment-jelmyto/

  FDA Approves Jelmyto For UTUC […] April 15, 2020 Today, the U.S. Food and Drug Administration approved Jelmyto (mitomycin gel), the first therapy to treat low-grade upper tract urothelial cancer (UTUC). […] This is the first approval specifically for patients with low-grade UTUC and provides an option for some patients who may otherwise require a nephroureterectomy.

• #5 Uretral Cancer Treatment | Fox Chase Cancer Center – Philadelphia PA

  https://www.foxchase.org/clinical-care/conditions/ureteral-cancer/treatment

  At Fox Chase Cancer Center, our multidisciplinary medical team works closely to accurately diagnose your ureteral cancer and help you understand your options so that you can make an informed decision about your treatment. […] As a regional and national leader in cancer care, Fox Chase has a wealth of experience treating all types of ureteral cancer. […] Our skilled, multispecialty genitourinary cancer team meets regularly to review patient cases and map out a personalized treatment plan. We strive to treat your cancer in the least invasive way possible using innovative surgical techniques and combination therapies that give you the best chance of a successful outcome. […] Our doctors are also actively involved in developing new therapies for treating ureteral cancer. Through clinical trials, we are able to offer our patients access to promising treatments and experimental therapies that may not be available elsewhere. Ask your Fox Chase doctor if a clinical trial is right for you.

• #6 Ureteral cancer – Care at Mayo Clinic – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ureteral-cancer/care-at-mayo-clinic/mac-20360724

  Laparoscopic surgery involves making several small cuts in your stomach area. Specialized surgical tools, including a camera, are inserted through the cuts and used to perform the surgery. […] Robotic surgery is a type of laparoscopic surgery in which the surgical tools are moved by a robot that’s controlled by the surgeon. Robotic surgery allows for more-precise movements in tight spaces. […] Mayo Clinic urologists are respected for their experience and expertise in diagnosing and treating ureteral cancer. At Mayo Clinic, you can expect personalized treatment. At Mayo Clinic, urologists work with oncologists, radiologists and pathologists, to create a personalized treatment plan. The personalized treatment plan takes into consideration all your needs. […] Each year, Mayo Clinic doctors care for many people with ureteral cancer. This experience with rare cancers means your care team is prepared with knowledge and resources to provide you with exactly the care you need. […] Mayo Clinic Comprehensive Cancer Center meets the strict standards for a National Cancer Institute-Designated Comprehensive Cancer Center. These standards recognize scientific excellence and a multispecialty approach focused on cancer prevention, diagnosis and treatment.

• #7 Transitional Cell Cancer of the Renal Pelvis and Ureter > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/transitional-cell-cancer-of-the-renal-pelvis-and-ureter

  A cancer that begins in cells in the renal pelvis and ureter, which are part of the upper urinary tract. […] Treatment includes surgery, chemotherapy, radiation, targeted therapy. […] The good news is that when transitional cell cancer of the renal pelvis and ureter is caught early, its very treatable. […] We now have a large number of treatments, ranging from surgery to immune therapies to chemotherapies, including combinations. […] Surgery is usually recommended as a first-line treatment to remove the affected kidney, renal pelvis, ureter, and bladder cuff (where the ureter connects to the bladder). […] After surgery, patients may undergo chemotherapy to help prevent cancer from developing in the bladder. […] For patients who cannot tolerate surgery, radiation plus chemotherapy is a standard-of-care treatment.

• #8 Treatments for cancer of the renal pelvis or ureter | Canadian Cancer Society

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

  If you have cancer of the renal pelvis or ureter, your healthcare team will create a treatment plan just for you. It will be based on your health and specific information about the cancer. When deciding which treatments to offer for cancer of the renal pelvis or ureter, your healthcare team will consider the stage and grade of the cancer. […] Surgery is the main treatment for cancer that is only in the renal pelvis or ureter. Depending on where the cancer is located and the stage of the cancer, you may have one of the following types of surgery. […] A radical nephroureterectomy is the most common surgery done for cancer of the renal pelvis or ureter. The surgeon removes the entire kidney, all of the ureter and the tissue where the ureter connects to the bladder (called the bladder cuff).

• #9 Ureter Cancer Treatment

  https://www.froedtert.com/prostate-cancer/bladder-ureteral-cancer/ureter-cancer

  The key to treating cancer of the ureter is tailoring the right therapy to the patients specific risk. […] Management of ureteral cancer depends on both the grade of the tumor and where it is located. […] Because of this increased likelihood of developing new tumors, it is important whenever possible to use treatment strategies that will preserve the kidney and ureter. […] Some ureteral cancers can be treated using minimally invasive surgical techniques. […] Some cases of ureter cancer require the surgical removal of the ureter, also known as ureterectomy. […] Patients with a ureter cancer in a higher risk category who have undergone surgery can benefit from drug therapy. […] Ureter cancers that have spread to other parts of the body are treated the same as metastatic bladder cancer. […] Some patients with ureter cancer benefit from radiation to the area of the tumor.

• #10 Ureter Cancer Treatment

  https://www.froedtert.com/prostate-cancer/bladder-ureteral-cancer/ureter-cancer

  The key to treating cancer of the ureter is tailoring the right therapy to the patients specific risk. […] Management of ureteral cancer depends on both the grade of the tumor and where it is located. […] Because of this increased likelihood of developing new tumors, it is important whenever possible to use treatment strategies that will preserve the kidney and ureter. […] Some ureteral cancers can be treated using minimally invasive surgical techniques. […] Some cases of ureter cancer require the surgical removal of the ureter, also known as ureterectomy. […] Patients with a ureter cancer in a higher risk category who have undergone surgery can benefit from drug therapy. […] Ureter cancers that have spread to other parts of the body are treated the same as metastatic bladder cancer. […] Some patients with ureter cancer benefit from radiation to the area of the tumor.

• #11 Treatments for cancer of the renal pelvis or ureter | Canadian Cancer Society

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

  If you have cancer of the renal pelvis or ureter, your healthcare team will create a treatment plan just for you. It will be based on your health and specific information about the cancer. When deciding which treatments to offer for cancer of the renal pelvis or ureter, your healthcare team will consider the stage and grade of the cancer. […] Surgery is the main treatment for cancer that is only in the renal pelvis or ureter. Depending on where the cancer is located and the stage of the cancer, you may have one of the following types of surgery. […] A radical nephroureterectomy is the most common surgery done for cancer of the renal pelvis or ureter. The surgeon removes the entire kidney, all of the ureter and the tissue where the ureter connects to the bladder (called the bladder cuff).

• #12 Transitional Cell Cancer (Kidney/Ureter) Treatment – NCI

  https://www.cancer.gov/types/kidney/patient/transitional-cell-treatment-pdq

  Transitional cell cancer of the renal pelvis and ureter is a type of cancer that forms in the transitional cells of the renal pelvis and ureter. […] There are different types of treatment for patients with transitional cell cancer of the renal pelvis and ureter. […] The following type of treatment is used: Surgery. […] One of the following surgical procedures may be used to treat transitional cell cancer of the renal pelvis and ureter: Nephroureterectomy is surgery to remove the entire kidney, the ureter, and the bladder cuff (tissue that connects the ureter to the bladder). Most people with transitional cell cancer of the renal pelvis and ureter undergo nephroureterectomy. […] Segmental resection of the ureter is a surgical procedure to remove the part of the ureter that contains cancer and some of the healthy tissue around it. The ends of the ureter are then reattached. This treatment is used when the cancer is superficial and in the lower third of the ureter only, near the bladder.

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

  https://uroweb.org/guidelines/upper-urinary-tract-urothelial-cell-carcinoma/chapter/disease-management

  The antegrade instillation of BCG or mitomycin C in the upper urinary tract via percutaneous nephrostomy after complete tumour eradication has been studied for CIS after kidney-sparing management. […] Radical nephroureterectomy is the standard treatment for high-risk UTUC, regardless of tumour location. […] Open, laparoscopic and robotic approaches have similar oncological outcomes. […] Post-operative platinum-based adjuvant chemotherapy improves disease-free survival. […] Discuss kidney-sparing management to high-risk patients with imperative indication on a case-by-case basis, in a shared-decision making process with the patient despite the higher risk of disease progression. […] Enfortumab vedotin + Pembrolizumab offers an overall survival benefit compared to gemcitabine-cisplatin in the first-line setting. […] Cisplatin-based combination chemotherapy can improve median survival. […] Offer checkpoint inhibitors pembrolizumab or atezolizumab to patients with PD-L1 positive tumours.

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

  https://uroweb.org/guidelines/upper-urinary-tract-urothelial-cell-carcinoma/chapter/disease-management

  The antegrade instillation of BCG or mitomycin C in the upper urinary tract via percutaneous nephrostomy after complete tumour eradication has been studied for CIS after kidney-sparing management. […] Radical nephroureterectomy is the standard treatment for high-risk UTUC, regardless of tumour location. […] Open, laparoscopic and robotic approaches have similar oncological outcomes. […] Post-operative platinum-based adjuvant chemotherapy improves disease-free survival. […] Discuss kidney-sparing management to high-risk patients with imperative indication on a case-by-case basis, in a shared-decision making process with the patient despite the higher risk of disease progression. […] Enfortumab vedotin + Pembrolizumab offers an overall survival benefit compared to gemcitabine-cisplatin in the first-line setting. […] Cisplatin-based combination chemotherapy can improve median survival. […] Offer checkpoint inhibitors pembrolizumab or atezolizumab to patients with PD-L1 positive tumours.

• #15 Ureteral cancer – Care at Mayo Clinic – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ureteral-cancer/care-at-mayo-clinic/mac-20360724

  Laparoscopic surgery involves making several small cuts in your stomach area. Specialized surgical tools, including a camera, are inserted through the cuts and used to perform the surgery. […] Robotic surgery is a type of laparoscopic surgery in which the surgical tools are moved by a robot that’s controlled by the surgeon. Robotic surgery allows for more-precise movements in tight spaces. […] Mayo Clinic urologists are respected for their experience and expertise in diagnosing and treating ureteral cancer. At Mayo Clinic, you can expect personalized treatment. At Mayo Clinic, urologists work with oncologists, radiologists and pathologists, to create a personalized treatment plan. The personalized treatment plan takes into consideration all your needs. […] Each year, Mayo Clinic doctors care for many people with ureteral cancer. This experience with rare cancers means your care team is prepared with knowledge and resources to provide you with exactly the care you need. […] Mayo Clinic Comprehensive Cancer Center meets the strict standards for a National Cancer Institute-Designated Comprehensive Cancer Center. These standards recognize scientific excellence and a multispecialty approach focused on cancer prevention, diagnosis and treatment.

• #16 Ureter Cancer Treatment in NJ | Hackensack Meridian Health Urology

  https://www.hackensackmeridianhealth.org/en/services/urology/ureter-cancer

  No one has more experience in New Jersey than Hackensack Meridian Health in performing robotic surgery for cancer of the ureter. We specialize in treatment that is minimally invasive and preserves your ureter, your kidney and your quality of life. […] The urologists at Hackensack Meridian Health are recognized worldwide as leaders in robotic surgery. We are highly experienced in robotic and minimally invasive surgeries for cancer in the ureter and renal pelvis. Our goal is to treat your cancer while removing the least amount of your ureter and kidney. Depending on the location and how advanced your cancer is, our team may perform one of these robotic procedures: […] When it comes to treating your ureter cancer, our urology team will recommend the most effective treatment for your cancer while preserving your ureter and kidney whenever possible. We collaborate with specialists across John Theurer Cancer Center on state-of-the-art treatment methods, including:

• #17 Urothelial Tumors of the Renal Pelvis and Ureters Guidelines: Guidelines Summary

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

  The EAU guidelines include the following key treatment recommendations: Kidney-sparing management (flexible ureteroscopy or segmental resection or percutaneous approach) is the primary treatment option for low-risk tumors. Offer kidney-sparing management to high-risk patients with imperative indication on a case-by-case basis, in consultation with the patient. Perform radical nephroureterectomy (RNU) in patients with high-risk non-metastatic UTUC. […] Perform open RNU in nonorgan-confined UTUC (cT3, cN+). […] Perform a template-based lymphadenectomy in patients with high-risk non-metastatic UTUC. […] Deliver a postoperative bladder instillation of chemotherapy to lower the intravesical recurrence rate. […] Offer adjuvant platinum-based systemic chemotherapy after RNU to patients with pT2T4 and/or pN+ disease; offer gemcitabine/carboplatin chemotherapy to cisplatin-ineligible patients.

• #18 Treatments for cancer of the renal pelvis or ureter | Canadian Cancer Society

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

  A segmental resection of the ureter is usually only done to remove small tumours in the lower part of the ureter closest to the bladder. […] Endoscopic surgery is when the surgeon removes the tumour using an endoscope and cutting tools passed through the endoscope. It may be done for cancer of the renal pelvis or ureter that is low grade and at an early stage. […] Chemotherapy uses anticancer (cytotoxic) drugs to destroy cancer cells. It can be used before surgery (neoadjuvant chemotherapy) or after surgery (adjuvant chemotherapy) to treat cancer of the renal pelvis or ureter that has spread to the lymph nodes or other parts of the body. […] Immunotherapy helps to strengthen or restore the immune systems ability to find and destroy cancer cells. It may be used to treat advanced or metastatic urothelial carcinoma when chemotherapy doesnt work.

• #19 Transitional Cell Cancer (Kidney/Ureter) Treatment – NCI

  https://www.cancer.gov/types/kidney/patient/transitional-cell-treatment-pdq

  Transitional cell cancer of the renal pelvis and ureter is a type of cancer that forms in the transitional cells of the renal pelvis and ureter. […] There are different types of treatment for patients with transitional cell cancer of the renal pelvis and ureter. […] The following type of treatment is used: Surgery. […] One of the following surgical procedures may be used to treat transitional cell cancer of the renal pelvis and ureter: Nephroureterectomy is surgery to remove the entire kidney, the ureter, and the bladder cuff (tissue that connects the ureter to the bladder). Most people with transitional cell cancer of the renal pelvis and ureter undergo nephroureterectomy. […] Segmental resection of the ureter is a surgical procedure to remove the part of the ureter that contains cancer and some of the healthy tissue around it. The ends of the ureter are then reattached. This treatment is used when the cancer is superficial and in the lower third of the ureter only, near the bladder.

• #20 Ureter Cancer | Baptist Health

  https://www.baptisthealth.com/care-services/conditions-treatments/ureter-cancer

  Surgery can include removal of a portion of the ureter, the whole ureter or the ureter and kidney. Sometimes a portion of the bladder is also removed. Surgical procedures may include: Nephrectomy: In this procedure, part or all of the kidney is removed. […] Ureterectomy: The procedure involves removal of the entire ureter. […] Ureteroneocystomy (reimplantation): If cancer cells are only in the lower part of the ureter, this procedure removes only the lower part. The remaining section of the ureter is reconnected to the bladder. […] Ureter cancer sometimes recurs, or puts you at a greater risk of other urinary tract cancers, so follow-up care for years after successful treatment is important.

• #21 Treatments for cancer of the renal pelvis or ureter | Canadian Cancer Society

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

  A segmental resection of the ureter is usually only done to remove small tumours in the lower part of the ureter closest to the bladder. […] Endoscopic surgery is when the surgeon removes the tumour using an endoscope and cutting tools passed through the endoscope. It may be done for cancer of the renal pelvis or ureter that is low grade and at an early stage. […] Chemotherapy uses anticancer (cytotoxic) drugs to destroy cancer cells. It can be used before surgery (neoadjuvant chemotherapy) or after surgery (adjuvant chemotherapy) to treat cancer of the renal pelvis or ureter that has spread to the lymph nodes or other parts of the body. […] Immunotherapy helps to strengthen or restore the immune systems ability to find and destroy cancer cells. It may be used to treat advanced or metastatic urothelial carcinoma when chemotherapy doesnt work.

• #22 Ureteral cancer – Care at Mayo Clinic – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ureteral-cancer/care-at-mayo-clinic/mac-20360724

  Mayo Clinic urologists have experience diagnosing and treating ureteral cancer. They draw on their knowledge and expertise to create a personalized treatment plan that meets your goals and needs. […] Mayo Clinic doctors will work with you to review all your treatment options and choose the treatment that best suits your needs and goals. Treatments offered to people with ureteral cancer include chemotherapy, targeted therapy, immunotherapy and a variety of surgical procedures. […] At Mayo Clinic, surgeons are highly skilled in the latest minimally invasive surgery techniques. Whenever possible, surgeons prefer to use minimally invasive surgery to remove ureteral cancer. […] Endoscopic surgery allows certain ureteral cancers to be removed during ureteroscopy. Special surgical tools can be passed through the scope to remove the cancer.

• #23 Transitional Cell Cancer: Causes, Signs, and Treatment

  https://www.healthline.com/health/cancer-renal-pelvis-or-ureter

  Current treatments for transitional cell carcinoma include: […] Endoscopic resection, fulguration, or laser surgery. Through a ureteroscope, physicians can destroy or remove cancer cells with direct tumor removal, electrical current, or laser. […] Segmental resection. This procedure involves the removal of the part of the ureter that contains the cancer. […] Nephroureterectomy. This procedure involves the removal of the kidney, ureter, and bladder tissue. […] Your doctor may also use other treatments to make sure the cancer doesn’t come back. These can include: […] chemotherapy […] anticancer drugs […] biological therapies that kill cancer cells or prevent them from growing.

• #24 Transitional Cell Cancer (Kidney/Ureter) Treatment – NCI

  https://www.cancer.gov/types/kidney/patient/transitional-cell-treatment-pdq

  New types of treatment are being tested in clinical trials. […] Fulguration is a surgical procedure that destroys tissue using an electric current. A tool with a small wire loop on the end is used to remove the cancer or to burn away the tumor with electricity. […] This is a surgical procedure to remove localized cancer from the renal pelvis without removing the entire kidney. Segmental resection may be done to save kidney function when the other kidney is damaged or has already been removed. […] Regional treatment for transitional cell cancer of renal pelvis and ureter is a method of placing the chemotherapy or immunotherapy drug directly into the renal pelvis or the ureter to mainly affect cancer cells in those areas. […] Treatment of localized transitional cell cancer of the renal pelvis and ureter may include: surgery (nephroureterectomy or segmental resection of ureter), a clinical trial of fulguration, a clinical trial of laser surgery, a clinical trial of segmental resection of the renal pelvis, a clinical trial of regional chemotherapy or regional immunotherapy. […] Treatment of regional transitional cell cancer of the renal pelvis and ureter is usually done in a clinical trial. […] Treatment of metastatic or recurrent transitional cell cancer of the renal pelvis and ureter is usually done in a clinical trial, which may include chemotherapy.

• #25 What is Ureteral Cancer?

  https://blog.dana-farber.org/insight/2021/12/what-is-ureteral-cancer/

  There are different types of treatment for patients with ureteral cancer. Treatments will depend on various factors including tumor size, tumor location, and tumor aggressiveness. Ureter cancer that is high-grade on pathology examination may require intravenous chemotherapy before or after surgery to improve the cure rate. In addition, intravenous immunotherapy using a drug called nivolumab is now approved for certain patients following surgery who are not eligible for chemotherapy. […] Types of surgical options can include: Nephroureterectomy: The majority of ureteral cancers are treated with this type of surgery to remove the kidney and the entire ureter. […] Clinical trials are also testing potential new treatments, including: Fulguration, a surgical procedure that destroys tissue using an electric current. A tool with a small wire loop on the end is used to remove the cancer or to burn away the tumor with electricity.

• #26 Transitional Cell Cancer of the Renal Pelvis and Ureter > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/transitional-cell-cancer-of-the-renal-pelvis-and-ureter

  Doctors may use a laser to target and kill cancer cells within the renal pelvis or ureter. […] Some people who have low-grade, localized transitional cell cancer of the renal pelvis and ureter may not need to have their kidneys removed. Instead, doctors may surgically remove cancer from within the renal pelvis or ureter while leaving everything in place. […] Its helpful to get an early diagnosis of transitional cell cancer of the renal pelvis and ureter because the disease is highly curable when its treated before it spreads. […] At Yale, we see a very large number of bladder cancers, including those in the upper tract.

• #27 Ureter Cancer | Baptist Health

  https://www.baptisthealth.com/care-services/conditions-treatments/ureter-cancer

  Baptist Health is known for advanced, superior care for patients with cancer and the diagnosis, treatment and management of ureter cancer. […] Ureter cancer treatment depends upon how far the condition has progressed. The goal is to eliminate the cancer. […] After surgery, or if cancer has spread elsewhere in the body, special drugs designed to kill cancer cells can be given as a pill or injected into the bloodstream. […] If the cancer is detected at an early stage or only appears on the ureters surface, this procedure can destroy the tumor and adjacent tissue with an electric current. […] If the cancer is detected at an early stage or only appears on the ureters surface, a ureteroscope can be inserted into the ureter and a beam of laser light sent through to destroy the tumor. […] After surgery, or if cancer has spread elsewhere in the body, high-energy radiation is used to kill cancer cells. The radiation is directed specifically to the ureter and other affected tissues or organs.

• #28 Ureteral cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ureteral-cancer/diagnosis-treatment/drc-20360722

  Treatment options for ureteral cancer include surgery, chemotherapy, immunotherapy and targeted therapy. Treatment depends on many factors. These factors include the size and location of the cancer, how aggressive the cells are, and your own goals and preferences. […] Surgery is often recommended to remove ureteral cancer. The kind of surgery used for your ureteral cancer will depend on your cancer. […] For a small ureteral cancer that hasn’t spread beyond the ureter, surgery may remove only a portion of the ureter. […] For a ureteral cancer that grows larger or spreads beyond the ureter, it may be necessary to remove more. The surgeon may remove the affected ureter, its associated kidney and part of the bladder. This procedure is sometimes referred to as a nephroureterectomy. […] Chemotherapy treats cancer with strong medicines. Chemotherapy is sometimes used before surgery to shrink the cancer. This can make it easier to remove during surgery. Chemotherapy may be used after surgery to kill any cancer cells that may remain.

• #29 Ureteral cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ureteral-cancer/diagnosis-treatment/drc-20360722

  Treatment options for ureteral cancer include surgery, chemotherapy, immunotherapy and targeted therapy. Treatment depends on many factors. These factors include the size and location of the cancer, how aggressive the cells are, and your own goals and preferences. […] Surgery is often recommended to remove ureteral cancer. The kind of surgery used for your ureteral cancer will depend on your cancer. […] For a small ureteral cancer that hasn’t spread beyond the ureter, surgery may remove only a portion of the ureter. […] For a ureteral cancer that grows larger or spreads beyond the ureter, it may be necessary to remove more. The surgeon may remove the affected ureter, its associated kidney and part of the bladder. This procedure is sometimes referred to as a nephroureterectomy. […] Chemotherapy treats cancer with strong medicines. Chemotherapy is sometimes used before surgery to shrink the cancer. This can make it easier to remove during surgery. Chemotherapy may be used after surgery to kill any cancer cells that may remain.

• #30 Urothelial Tumors of the Renal Pelvis and Ureters Treatment & Management: Medical Therapy, Surgical Therapy, Follow-up

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

  Nephroureterectomy with excision of the bladder cuff is considered the standard therapy in patients with high-volume renal pelvis UTUC, regionally extensive disease, and high-grade or high-stage lesions. […] Neoadjuvant chemotherapy has been shown to confer survival advantage in two retrospective studies. […] A prospective phase II study of neoadjuvant chemotherapy found that in patients with high-grade UTUC and creatinine clearance greater than 50 mL/min, a regimen of accelerated methotrexate, vinblastine, doxorubicin and cisplatin neoadjuvant chemotherapy was safe and demonstrated predefined activity with a 14% pathologic complete response rate. […] Adjuvant therapy with biologic agents is gaining an increasing role in second-line therapy for patients with advanced or metastatic UTUC.

• #31 Urothelial Tumors of the Renal Pelvis and Ureters Treatment & Management: Medical Therapy, Surgical Therapy, Follow-up

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

  Nephroureterectomy with excision of the bladder cuff is considered the standard therapy in patients with high-volume renal pelvis UTUC, regionally extensive disease, and high-grade or high-stage lesions. […] Neoadjuvant chemotherapy has been shown to confer survival advantage in two retrospective studies. […] A prospective phase II study of neoadjuvant chemotherapy found that in patients with high-grade UTUC and creatinine clearance greater than 50 mL/min, a regimen of accelerated methotrexate, vinblastine, doxorubicin and cisplatin neoadjuvant chemotherapy was safe and demonstrated predefined activity with a 14% pathologic complete response rate. […] Adjuvant therapy with biologic agents is gaining an increasing role in second-line therapy for patients with advanced or metastatic UTUC.

• #32 Ureteral cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ureteral-cancer/diagnosis-treatment/drc-20360722

  Treatment options for ureteral cancer include surgery, chemotherapy, immunotherapy and targeted therapy. Treatment depends on many factors. These factors include the size and location of the cancer, how aggressive the cells are, and your own goals and preferences. […] Surgery is often recommended to remove ureteral cancer. The kind of surgery used for your ureteral cancer will depend on your cancer. […] For a small ureteral cancer that hasn’t spread beyond the ureter, surgery may remove only a portion of the ureter. […] For a ureteral cancer that grows larger or spreads beyond the ureter, it may be necessary to remove more. The surgeon may remove the affected ureter, its associated kidney and part of the bladder. This procedure is sometimes referred to as a nephroureterectomy. […] Chemotherapy treats cancer with strong medicines. Chemotherapy is sometimes used before surgery to shrink the cancer. This can make it easier to remove during surgery. Chemotherapy may be used after surgery to kill any cancer cells that may remain.

• #33 Urothelial Tumors of the Renal Pelvis and Ureters Treatment & Management: Medical Therapy, Surgical Therapy, Follow-up

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

  BCG is an attenuated form of Mycobacterium tuberculosis, and its use carries a small but significant risk of BCG sepsis. To prevent adverse systemic effects, BCG should not be used in patients with gross hematuria. […] Because of an ongoing shortage of BCG in the United States, the National Comprehensive Cancer Network and several urologic societies have recommended strategies on prioritizing use of intravesical BCG and alternative treatment approaches for some patients. […] The safety of BCG and mitomycin C as adjuvant therapy has been well studied in bladder cancer; however, their efficacy in decreasing recurrence rates, delaying tumor progression, and improving survival rates in upper urinary tract cancer has not been firmly established. […] A systematic review by Kim et al concluded that adjuvant chemotherapy after radical nephroureterectomy in patients with locally advanced UTUC may improve disease-free survival and cancer-specific survival.

• #34 Urothelial Tumors of the Renal Pelvis and Ureters Guidelines: Guidelines Summary

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

  The EAU guidelines include the following key treatment recommendations: Kidney-sparing management (flexible ureteroscopy or segmental resection or percutaneous approach) is the primary treatment option for low-risk tumors. Offer kidney-sparing management to high-risk patients with imperative indication on a case-by-case basis, in consultation with the patient. Perform radical nephroureterectomy (RNU) in patients with high-risk non-metastatic UTUC. […] Perform open RNU in nonorgan-confined UTUC (cT3, cN+). […] Perform a template-based lymphadenectomy in patients with high-risk non-metastatic UTUC. […] Deliver a postoperative bladder instillation of chemotherapy to lower the intravesical recurrence rate. […] Offer adjuvant platinum-based systemic chemotherapy after RNU to patients with pT2T4 and/or pN+ disease; offer gemcitabine/carboplatin chemotherapy to cisplatin-ineligible patients.

• #35 Ureteral cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ureteral-cancer/diagnosis-treatment/drc-20360722

  For advanced ureteral cancer, chemotherapy may be used to control symptoms of the cancer. […] Immunotherapy is a treatment with medicine that helps the body’s immune system kill cancer cells. The immune system fights off diseases by attacking germs and other cells that shouldn’t be in the body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the immune system cells find and kill the cancer cells. […] Immunotherapy might be an option for treating advanced ureteral cancer that spreads to nearby lymph nodes or other parts of the body. It is sometimes used in combination with targeted therapies. […] Targeted therapy for cancer is a treatment that uses medicines that attack specific chemicals in the cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die. Your cancer cells may be tested to see if targeted therapy is likely to be effective.

• #36 Upper urinary tract urothelial cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/upper-urinary-tract-urothelial-cancer

  Advanced upper urinary tract urothelial cancer means that the cancer has grown outside the kidney or ureter (locally advanced). Or has spread to another part of the body (metastatic cancer). The main treatments are chemotherapy and immunotherapy. […] You may have either: gemcitabine with cisplatin (GC), gemcitabine with carboplatin (GemCarbo). […] If the chemotherapy works well, after 4 to 6 cycles you might have an immunotherapy drug called avelumab. […] Radiotherapy isn’t often given for upper urinary tract urothelial cancer. You may have it after surgery if the cancer has spread to the tissue around the kidney.

• #37 Upper urinary tract urothelial cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/upper-urinary-tract-urothelial-cancer

  Advanced upper urinary tract urothelial cancer means that the cancer has grown outside the kidney or ureter (locally advanced). Or has spread to another part of the body (metastatic cancer). The main treatments are chemotherapy and immunotherapy. […] You may have either: gemcitabine with cisplatin (GC), gemcitabine with carboplatin (GemCarbo). […] If the chemotherapy works well, after 4 to 6 cycles you might have an immunotherapy drug called avelumab. […] Radiotherapy isn’t often given for upper urinary tract urothelial cancer. You may have it after surgery if the cancer has spread to the tissue around the kidney.

• #38 Transitional Cell Cancer (Kidney/Ureter) Treatment – NCI

  https://www.cancer.gov/types/kidney/patient/transitional-cell-treatment-pdq

  New types of treatment are being tested in clinical trials. […] Fulguration is a surgical procedure that destroys tissue using an electric current. A tool with a small wire loop on the end is used to remove the cancer or to burn away the tumor with electricity. […] This is a surgical procedure to remove localized cancer from the renal pelvis without removing the entire kidney. Segmental resection may be done to save kidney function when the other kidney is damaged or has already been removed. […] Regional treatment for transitional cell cancer of renal pelvis and ureter is a method of placing the chemotherapy or immunotherapy drug directly into the renal pelvis or the ureter to mainly affect cancer cells in those areas. […] Treatment of localized transitional cell cancer of the renal pelvis and ureter may include: surgery (nephroureterectomy or segmental resection of ureter), a clinical trial of fulguration, a clinical trial of laser surgery, a clinical trial of segmental resection of the renal pelvis, a clinical trial of regional chemotherapy or regional immunotherapy. […] Treatment of regional transitional cell cancer of the renal pelvis and ureter is usually done in a clinical trial. […] Treatment of metastatic or recurrent transitional cell cancer of the renal pelvis and ureter is usually done in a clinical trial, which may include chemotherapy.

• #39 Urothelial Tumors of the Renal Pelvis and Ureters Treatment & Management: Medical Therapy, Surgical Therapy, Follow-up

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

  Medical therapy for upper tract urothelial cell carcinoma (UTUC) can be topical or systemic. Topical chemotherapeutic agents are delivered by instillation and consist of bacillus Calmette-Gurin (BCG), which is the preferred agent, or mitomycin C. These agents can be administered either percutaneously or via a retrograde approach through a ureteral catheter. For high-grade disease, topical instillation therapy is most appropriate in patients for whom radical surgery is absolutely or relatively contraindicatedthose with bilateral disease and/or limited kidney function. […] In 2020 the US Food and Drug Administration approved mitomycin pyelocalyceal (Jelmyto) for treatment of low-grade upper tract urothelial cancer (LG-UTUC) in adults. Mitomycin pyelocalyceal is instilled via ureteral catheter or a nephrostomy tube. Approval was based on the OLYMPUS study, in which 41 of 71 patients (58%) achieved a complete response (CR) at 3 months, after receiving 6 weekly instillations of mitomycin pyelocalyceal. Patients with a CR at 3 months then received monthly instillations for a maximum of 11 additional instillations, and 46% of those patients remained in CR at the 12-month visit.

• #40 Tumor found in the Ureter – American Bladder Cancer Society

  https://bladdercancersupport.org/discussion/tumor-found-in-the-ureter/

  Recently, I had an MRI where a thickening of the ureter wall was found. After a ureteroscopy, a tumor was identified. My doctor took out a tissue sample and pathology will determine if the tumor is low grade or high grade at this point. […] If its low grade tumor, my urologist is recommending a series of ureteroscopies to remove the tumor and to keep an eye on the ureter for possible future tumors. Moreover, a stent is to be inserted to keep the ureter from closing. […] Ureter Cancer is frequently called Upper Tract Urothelial Carcinoma or UTUC. Using all three terms on google will provide many responses. […] One recent drug approval for Low Grade Upper Tract Urothelial Carcinoma (LGUTUC) is Gelmyto, a form of Gemcitabine. […] Maybe it is just me, and my situation, but I would want additional opinions and thoughts on how to address the ureter tumor problem before considering losing a kidney. Reliable sources on google (Cancer Society, well know major medical institutions, etc) will offer possibilities to discuss with your care team about ureter treatment.

• #41 Urothelial Tumors of the Renal Pelvis and Ureters Treatment & Management: Medical Therapy, Surgical Therapy, Follow-up

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

  BCG is an attenuated form of Mycobacterium tuberculosis, and its use carries a small but significant risk of BCG sepsis. To prevent adverse systemic effects, BCG should not be used in patients with gross hematuria. […] Because of an ongoing shortage of BCG in the United States, the National Comprehensive Cancer Network and several urologic societies have recommended strategies on prioritizing use of intravesical BCG and alternative treatment approaches for some patients. […] The safety of BCG and mitomycin C as adjuvant therapy has been well studied in bladder cancer; however, their efficacy in decreasing recurrence rates, delaying tumor progression, and improving survival rates in upper urinary tract cancer has not been firmly established. […] A systematic review by Kim et al concluded that adjuvant chemotherapy after radical nephroureterectomy in patients with locally advanced UTUC may improve disease-free survival and cancer-specific survival.

• #42 Urothelial Tumors of the Renal Pelvis and Ureters Treatment & Management: Medical Therapy, Surgical Therapy, Follow-up

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

  Systemic chemotherapy has an established role in patients with metastatic disease. Systemic chemotherapy may also be given as a neoadjuvant approach for patients with larger high-grade urothelial carcinomas, in a paradigm similar to that of neoadjuvant chemotherapy for muscle-invasive bladder cancer. Immunotherapy is used for second-line treatment of metastatic UTUC. […] Primary treatment is with surgery; the standard is radical nephroureterectomy with excision of bladder cuff. Recurrence rates are high (50%) in patients who do not undergo definitive extirpation and are treated with nephron-sparing approaches. […] Adjuvant topical treatments include retrograde or percutaneous instillation of mitomycin C. There is no demonstrable benefit of BCG in these settings. […] The efficacy of these agents in treating upper tract urothelial carcinoma is not well established because of the small retrospective studies with heterogeneous patients and tumor characteristics. Topical therapy should be reserved for patients who are not candidates for surgical extirpation due to poor kidney function, bilateral disease, or other co-morbid conditions.

• #43 Ureteral cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ureteral-cancer/diagnosis-treatment/drc-20360722

  For advanced ureteral cancer, chemotherapy may be used to control symptoms of the cancer. […] Immunotherapy is a treatment with medicine that helps the body’s immune system kill cancer cells. The immune system fights off diseases by attacking germs and other cells that shouldn’t be in the body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the immune system cells find and kill the cancer cells. […] Immunotherapy might be an option for treating advanced ureteral cancer that spreads to nearby lymph nodes or other parts of the body. It is sometimes used in combination with targeted therapies. […] Targeted therapy for cancer is a treatment that uses medicines that attack specific chemicals in the cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die. Your cancer cells may be tested to see if targeted therapy is likely to be effective.

• #44 Urothelial Tumors of the Renal Pelvis and Ureters Guidelines: Guidelines Summary

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

  Discuss adjuvant nivolumab with patients who are unfit for, or who declined, platinum-based adjuvant chemotherapy for pT3 and/or pN+ disease after RNU alone or ypT2 and/or ypN+ disease after neoadjuvant chemotherapy, followed by RNU. […] Offer the checkpoint inhibitors pembrolizumab or atezolizumab to patients with programmed death ligand 1 (PD-L1)positive tumors. […] Offer enfortumab vedotin to patients previously treated with platinum-containing chemotherapy and who had disease progression during or after treatment with a PD-1 or PD-L1 inhibitor. […] Offer erdafitinib as subsequent-line therapy to patients with platinum-refractory UTUC with FGFR DNA genomic alterations (FGFR2/3 mutations or FGFR3 fusions).

• #45 Urothelial Tumors of the Renal Pelvis and Ureters Treatment & Management: Medical Therapy, Surgical Therapy, Follow-up

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

  European Association of Urology guidelines recommend offering adjuvant nivolumab to patients who are unfit for, or who declined, platinum-based adjuvant chemotherapy for pT3 and/or pN+ disease after radical nephroureterectomy (RNU) alone or ypT2 and/or ypN+ disease after neoadjuvant chemotherapy, followed by RNU. […] The use of adjuvant chemotherapy did not result in longer cancer-specific survival; however, in that study, the patients who received chemotherapy had higher grade and stage disease. […] The final decision regarding the utility and extent of lymphadenectomy is at the discretion of the surgeon and can be modified by the intraoperative findings.

• #46 Urothelial Tumors of the Renal Pelvis and Ureters Guidelines: Guidelines Summary

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

  Discuss adjuvant nivolumab with patients who are unfit for, or who declined, platinum-based adjuvant chemotherapy for pT3 and/or pN+ disease after RNU alone or ypT2 and/or ypN+ disease after neoadjuvant chemotherapy, followed by RNU. […] Offer the checkpoint inhibitors pembrolizumab or atezolizumab to patients with programmed death ligand 1 (PD-L1)positive tumors. […] Offer enfortumab vedotin to patients previously treated with platinum-containing chemotherapy and who had disease progression during or after treatment with a PD-1 or PD-L1 inhibitor. […] Offer erdafitinib as subsequent-line therapy to patients with platinum-refractory UTUC with FGFR DNA genomic alterations (FGFR2/3 mutations or FGFR3 fusions).

• #47 Upper urinary tract urothelial cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/upper-urinary-tract-urothelial-cancer

  Advanced upper urinary tract urothelial cancer means that the cancer has grown outside the kidney or ureter (locally advanced). Or has spread to another part of the body (metastatic cancer). The main treatments are chemotherapy and immunotherapy. […] You may have either: gemcitabine with cisplatin (GC), gemcitabine with carboplatin (GemCarbo). […] If the chemotherapy works well, after 4 to 6 cycles you might have an immunotherapy drug called avelumab. […] Radiotherapy isn’t often given for upper urinary tract urothelial cancer. You may have it after surgery if the cancer has spread to the tissue around the kidney.

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

  https://uroweb.org/guidelines/upper-urinary-tract-urothelial-cell-carcinoma/chapter/disease-management

  The antegrade instillation of BCG or mitomycin C in the upper urinary tract via percutaneous nephrostomy after complete tumour eradication has been studied for CIS after kidney-sparing management. […] Radical nephroureterectomy is the standard treatment for high-risk UTUC, regardless of tumour location. […] Open, laparoscopic and robotic approaches have similar oncological outcomes. […] Post-operative platinum-based adjuvant chemotherapy improves disease-free survival. […] Discuss kidney-sparing management to high-risk patients with imperative indication on a case-by-case basis, in a shared-decision making process with the patient despite the higher risk of disease progression. […] Enfortumab vedotin + Pembrolizumab offers an overall survival benefit compared to gemcitabine-cisplatin in the first-line setting. […] Cisplatin-based combination chemotherapy can improve median survival. […] Offer checkpoint inhibitors pembrolizumab or atezolizumab to patients with PD-L1 positive tumours.

• #49 Renal Pelvis and Ureter Cancers – Kidney and Urinary Tract Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/kidney-and-urinary-tract-disorders/cancers-of-the-kidney-and-genitourinary-tract/renal-pelvis-and-ureter-cancers

  Occasionally, a medication, such as mitomycin C or bacille Calmette-Gurin (BCGa substance that stimulates the bodys immune system), is instilled into the ureter or a chemotherapy medication is given. […] A cystoscopy (insertion of a flexible viewing tube to examine the inside of the bladder) is done periodically after surgery, indefinitely, because people who have had this type of cancer are at risk of developing bladder cancer.

• #50 Ureteral cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ureteral-cancer/diagnosis-treatment/drc-20360722

  For advanced ureteral cancer, chemotherapy may be used to control symptoms of the cancer. […] Immunotherapy is a treatment with medicine that helps the body’s immune system kill cancer cells. The immune system fights off diseases by attacking germs and other cells that shouldn’t be in the body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the immune system cells find and kill the cancer cells. […] Immunotherapy might be an option for treating advanced ureteral cancer that spreads to nearby lymph nodes or other parts of the body. It is sometimes used in combination with targeted therapies. […] Targeted therapy for cancer is a treatment that uses medicines that attack specific chemicals in the cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die. Your cancer cells may be tested to see if targeted therapy is likely to be effective.

• #51 Ureteral cancer | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20314003/

  Immunotherapy is a treatment with medicine that helps the body’s immune system kill cancer cells. […] Targeted therapy for cancer is a treatment that uses medicines that attack specific chemicals in the cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die. Your cancer cells may be tested to see if targeted therapy is likely to be effective. […] Follow-up examinations […] After your treatment, your healthcare team may create a schedule of follow-up exams. During these exams, the team checks for signs that your cancer has returned. The team also looks for signs of bladder cancer, since people diagnosed with ureteral cancer have an increased risk of bladder cancer.

• #52 Urothelial Tumors of the Renal Pelvis and Ureters Guidelines: Guidelines Summary

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

  Discuss adjuvant nivolumab with patients who are unfit for, or who declined, platinum-based adjuvant chemotherapy for pT3 and/or pN+ disease after RNU alone or ypT2 and/or ypN+ disease after neoadjuvant chemotherapy, followed by RNU. […] Offer the checkpoint inhibitors pembrolizumab or atezolizumab to patients with programmed death ligand 1 (PD-L1)positive tumors. […] Offer enfortumab vedotin to patients previously treated with platinum-containing chemotherapy and who had disease progression during or after treatment with a PD-1 or PD-L1 inhibitor. […] Offer erdafitinib as subsequent-line therapy to patients with platinum-refractory UTUC with FGFR DNA genomic alterations (FGFR2/3 mutations or FGFR3 fusions).

• #53 Urothelial Tumors of the Renal Pelvis and Ureters Guidelines: Guidelines Summary

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

  Discuss adjuvant nivolumab with patients who are unfit for, or who declined, platinum-based adjuvant chemotherapy for pT3 and/or pN+ disease after RNU alone or ypT2 and/or ypN+ disease after neoadjuvant chemotherapy, followed by RNU. […] Offer the checkpoint inhibitors pembrolizumab or atezolizumab to patients with programmed death ligand 1 (PD-L1)positive tumors. […] Offer enfortumab vedotin to patients previously treated with platinum-containing chemotherapy and who had disease progression during or after treatment with a PD-1 or PD-L1 inhibitor. […] Offer erdafitinib as subsequent-line therapy to patients with platinum-refractory UTUC with FGFR DNA genomic alterations (FGFR2/3 mutations or FGFR3 fusions).

• #54 Urothelial Tumors of the Renal Pelvis and Ureters Guidelines: Guidelines Summary

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

  Discuss adjuvant nivolumab with patients who are unfit for, or who declined, platinum-based adjuvant chemotherapy for pT3 and/or pN+ disease after RNU alone or ypT2 and/or ypN+ disease after neoadjuvant chemotherapy, followed by RNU. […] Offer the checkpoint inhibitors pembrolizumab or atezolizumab to patients with programmed death ligand 1 (PD-L1)positive tumors. […] Offer enfortumab vedotin to patients previously treated with platinum-containing chemotherapy and who had disease progression during or after treatment with a PD-1 or PD-L1 inhibitor. […] Offer erdafitinib as subsequent-line therapy to patients with platinum-refractory UTUC with FGFR DNA genomic alterations (FGFR2/3 mutations or FGFR3 fusions).

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

  https://uroweb.org/guidelines/upper-urinary-tract-urothelial-cell-carcinoma/chapter/disease-management

  The antegrade instillation of BCG or mitomycin C in the upper urinary tract via percutaneous nephrostomy after complete tumour eradication has been studied for CIS after kidney-sparing management. […] Radical nephroureterectomy is the standard treatment for high-risk UTUC, regardless of tumour location. […] Open, laparoscopic and robotic approaches have similar oncological outcomes. […] Post-operative platinum-based adjuvant chemotherapy improves disease-free survival. […] Discuss kidney-sparing management to high-risk patients with imperative indication on a case-by-case basis, in a shared-decision making process with the patient despite the higher risk of disease progression. […] Enfortumab vedotin + Pembrolizumab offers an overall survival benefit compared to gemcitabine-cisplatin in the first-line setting. […] Cisplatin-based combination chemotherapy can improve median survival. […] Offer checkpoint inhibitors pembrolizumab or atezolizumab to patients with PD-L1 positive tumours.

• #56 Treatments for cancer of the renal pelvis or ureter | Canadian Cancer Society

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

  Radiation therapy uses high-energy rays or particles to destroy cancer cells. During external radiation therapy, a machine directs radiation through the skin to the area with the cancer and some of the tissue around it. It is not usually used for cancer of the renal pelvis or ureter, but in some cases, it can be given to relieve pain or control other symptoms of advanced cancer (called palliative radiation therapy).

• #57

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

  If your cancer has spread and is now known as advanced or metastatic upper urothelial cancer you may be offered immunotherapy, which uses the bodys own immune system to fight cancer. […] Radiation therapy uses high energy x-rays to destroy cancer cells, however it is less commonly used for UTUC. Your doctor will discuss your options with you.

• #58 Treatments for cancer of the renal pelvis or ureter | Canadian Cancer Society

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

  Radiation therapy uses high-energy rays or particles to destroy cancer cells. During external radiation therapy, a machine directs radiation through the skin to the area with the cancer and some of the tissue around it. It is not usually used for cancer of the renal pelvis or ureter, but in some cases, it can be given to relieve pain or control other symptoms of advanced cancer (called palliative radiation therapy).

• #59 Upper urinary tract urothelial cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/upper-urinary-tract-urothelial-cancer

  Advanced upper urinary tract urothelial cancer means that the cancer has grown outside the kidney or ureter (locally advanced). Or has spread to another part of the body (metastatic cancer). The main treatments are chemotherapy and immunotherapy. […] You may have either: gemcitabine with cisplatin (GC), gemcitabine with carboplatin (GemCarbo). […] If the chemotherapy works well, after 4 to 6 cycles you might have an immunotherapy drug called avelumab. […] Radiotherapy isn’t often given for upper urinary tract urothelial cancer. You may have it after surgery if the cancer has spread to the tissue around the kidney.

• #60 Proton beam therapy for renal pelvis and ureter cancer: A report of 5 cases and a literature review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6547882/

  Standard treatment for localized renal pelvis and ureter cancer is surgery. […] In this report, we describe 5 patients with the disease treated with proton beam therapy (PBT) as curative treatment. […] PBT appears to be a potential option for patients with renal pelvis or ureter cancer, especially for those who are unsuitable for radical surgery. […] The gold standard for curative treatment of localized renal pelvis and ureter cancer is open or laparoscopic surgery. […] However, delivery of curative doses safely is challenging, as the small intestine and colon may be extensively irradiated during photon RT for patients with these tumors. […] Therefore, it is necessary for patients unfit for surgery including patients with unresectable tumors or medically inoperable condition to devise new approaches in the curative setting.

• #61 Proton beam therapy for renal pelvis and ureter cancer: A report of 5 cases and a literature review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6547882/

  PBT can deliver conformal high-dose irradiation to the target while minimizing radiation-induced complications in surrounding healthy tissue. […] In our institute, we have treated 5 patients treated with definitive PBT, and herein describe our experience to explore the potential effectiveness of PBT as a curative treatment for renal pelvis and ureter cancer patients unfit for surgery. […] PBT for all 5 patients was performed without combining it with photon RT. […] The first 2 cases with T1-2N0M0 disease were treated with local PBT at a total dose of 66.0/72.6 Gy (RBE) in 22 fractions with a fractional dose of 3.0/3.3 Gy (RBE). […] In conclusion, this is the first report of curative PBT for localized renal pelvis and ureter cancers. […] The present results demonstrate that PBT may be effective and feasible as a curative treatment modality for the disease, and it probably has the potential to become a good candidate as an alternative radiotherapy for inoperable patients with early or locally advanced upper urinary tract cancer patients.

• #62 Proton beam therapy for renal pelvis and ureter cancer: A report of 5 cases and a literature review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6547882/

  PBT can deliver conformal high-dose irradiation to the target while minimizing radiation-induced complications in surrounding healthy tissue. […] In our institute, we have treated 5 patients treated with definitive PBT, and herein describe our experience to explore the potential effectiveness of PBT as a curative treatment for renal pelvis and ureter cancer patients unfit for surgery. […] PBT for all 5 patients was performed without combining it with photon RT. […] The first 2 cases with T1-2N0M0 disease were treated with local PBT at a total dose of 66.0/72.6 Gy (RBE) in 22 fractions with a fractional dose of 3.0/3.3 Gy (RBE). […] In conclusion, this is the first report of curative PBT for localized renal pelvis and ureter cancers. […] The present results demonstrate that PBT may be effective and feasible as a curative treatment modality for the disease, and it probably has the potential to become a good candidate as an alternative radiotherapy for inoperable patients with early or locally advanced upper urinary tract cancer patients.

• #63 Postoperative adjuvant radiotherapy for patients with upper tract urothelial carcinoma (UTUC) who underwent kidney-sparing surgery (KSS): a single-center study | Radiation Oncology | Full Text

  https://ro-journal.biomedcentral.com/articles/10.1186/s13014-023-02303-7

  The purpose of this study was to evaluate the efficacy of postoperative adjuvant radiotherapy for patients with upper tract urothelial carcinoma (UTUC) who underwent kidney-sparing surgery (KSS). […] All of the patients completed radiotherapy on schedule, and no grade 34 late-stage reaction was observed. […] Adjuvant radiotherapy is safe and tolerated, and LRFS was superior in middle and distal ureteral cancer than in proximal ureteral cancer. […] The effectiveness of postoperative adjuvant radiotherapy for UTUC has been controversial. […] In our respective study, the estimated 5-year OS, DFS and LC rates of patients were 64.0%, 61.1%, and 69.6%, respectively. […] Therefore, for patients with kidney protection requirements (especially older patients), postoperative adjuvant radiotherapy may be a feasible choice.

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

  https://uroweb.org/guidelines/upper-urinary-tract-urothelial-cell-carcinoma/chapter/disease-management

  All patients with suspicion of UTUC based on radiology, cystoscopy and urine cytology should be discussed in a multidisciplinary team prior to diagnostic ureteroscopy and the initiation of treatment. […] Kidney-sparing surgery for low-risk UTUC reduces the morbidity associated with RNU (e.g., loss of kidney function), without compromising oncological outcomes. In low-risk cancers, kidney-sparing surgery is the preferred approach as survival is similar to that after RNU. […] Endoscopic ablation should be considered in patients with low-risk cancer. […] A systematic review reported comparable survival outcomes after endoscopic treatment to RNU at the cost of higher local recurrence rates and repeated interventions, but also with some uncertainties about long-term renal preservation after endoscopic treatment.

• #65 Transitional Cell Cancer (Kidney/Ureter) Treatment – NCI

  https://www.cancer.gov/types/kidney/patient/transitional-cell-treatment-pdq

  New types of treatment are being tested in clinical trials. […] Fulguration is a surgical procedure that destroys tissue using an electric current. A tool with a small wire loop on the end is used to remove the cancer or to burn away the tumor with electricity. […] This is a surgical procedure to remove localized cancer from the renal pelvis without removing the entire kidney. Segmental resection may be done to save kidney function when the other kidney is damaged or has already been removed. […] Regional treatment for transitional cell cancer of renal pelvis and ureter is a method of placing the chemotherapy or immunotherapy drug directly into the renal pelvis or the ureter to mainly affect cancer cells in those areas. […] Treatment of localized transitional cell cancer of the renal pelvis and ureter may include: surgery (nephroureterectomy or segmental resection of ureter), a clinical trial of fulguration, a clinical trial of laser surgery, a clinical trial of segmental resection of the renal pelvis, a clinical trial of regional chemotherapy or regional immunotherapy. […] Treatment of regional transitional cell cancer of the renal pelvis and ureter is usually done in a clinical trial. […] Treatment of metastatic or recurrent transitional cell cancer of the renal pelvis and ureter is usually done in a clinical trial, which may include chemotherapy.

• #66 Ureter Cancer | Diagnosis and Treatment

  https://www.genesiscareus.com/en/condition/cancer/ureter-cancer

  Chemotherapy uses cytotoxic (anti-cancer) drugs to destroy cancer cells. You may take chemotherapy drugs orally (by mouth, in pill form) or intravenously (as a liquid, through a vein). […] Participating in a clinical trial can give you access to the latest in emerging treatment options for ureter cancer. […] This treatment works with your body’s immune system to fight the cancer. Your oncologist may recommend immunotherapy if your ureter cancer has not responded to other treatments.

• #67 Ureter Cancer Treatment in NJ | Hackensack Meridian Health Urology

  https://www.hackensackmeridianhealth.org/en/services/urology/ureter-cancer

  Holmium laser can be effective in treating cancer if detected early or found only on the surface of the ureter. […] Chemotherapy uses medications to kill cancer cells. Our team of urologists works with medical oncology colleagues at the John Theurer Cancer Center to determine if systemic chemotherapy is appropriate for you. We offer the latest, most promising chemotherapy treatments designed to target ureter cancer, either: […] Search our network of expert ureter cancer urologists and treatment locations across New Jersey and make an appointment today. […] The Department of Urology at Hackensack University Medical Center, a nationally ranked program by U.S. News World Report, is renowned for its high-quality urologic care, including excellence in research and clinical outcomes. […] A hallmark of the care we provide is access to a wide range of clinical trials evaluating exciting new treatments, including studies not available elsewhere.

• #68 Transitional Cell Cancer (Kidney/Ureter) Treatment – NCI

  https://www.cancer.gov/types/kidney/patient/transitional-cell-treatment-pdq

  New types of treatment are being tested in clinical trials. […] Fulguration is a surgical procedure that destroys tissue using an electric current. A tool with a small wire loop on the end is used to remove the cancer or to burn away the tumor with electricity. […] This is a surgical procedure to remove localized cancer from the renal pelvis without removing the entire kidney. Segmental resection may be done to save kidney function when the other kidney is damaged or has already been removed. […] Regional treatment for transitional cell cancer of renal pelvis and ureter is a method of placing the chemotherapy or immunotherapy drug directly into the renal pelvis or the ureter to mainly affect cancer cells in those areas. […] Treatment of localized transitional cell cancer of the renal pelvis and ureter may include: surgery (nephroureterectomy or segmental resection of ureter), a clinical trial of fulguration, a clinical trial of laser surgery, a clinical trial of segmental resection of the renal pelvis, a clinical trial of regional chemotherapy or regional immunotherapy. […] Treatment of regional transitional cell cancer of the renal pelvis and ureter is usually done in a clinical trial. […] Treatment of metastatic or recurrent transitional cell cancer of the renal pelvis and ureter is usually done in a clinical trial, which may include chemotherapy.

• #69 Uretral Cancer Treatment | Fox Chase Cancer Center – Philadelphia PA

  https://www.foxchase.org/clinical-care/conditions/ureteral-cancer/treatment

  At Fox Chase Cancer Center, our multidisciplinary medical team works closely to accurately diagnose your ureteral cancer and help you understand your options so that you can make an informed decision about your treatment. […] As a regional and national leader in cancer care, Fox Chase has a wealth of experience treating all types of ureteral cancer. […] Our skilled, multispecialty genitourinary cancer team meets regularly to review patient cases and map out a personalized treatment plan. We strive to treat your cancer in the least invasive way possible using innovative surgical techniques and combination therapies that give you the best chance of a successful outcome. […] Our doctors are also actively involved in developing new therapies for treating ureteral cancer. Through clinical trials, we are able to offer our patients access to promising treatments and experimental therapies that may not be available elsewhere. Ask your Fox Chase doctor if a clinical trial is right for you.

• #70 Ureteral cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ureteral-cancer/diagnosis-treatment/drc-20360722

  Targeted therapy may be used for treating advanced ureteral cancer. […] After your treatment, your healthcare team may create a schedule of follow-up exams. During these exams, the team checks for signs that your cancer has returned. The team also looks for signs of bladder cancer, since people diagnosed with ureteral cancer have an increased risk of bladder cancer.

• #71 Ureteral cancer | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/ureteral-cancer

  Immunotherapy might be an option for treating advanced ureteral cancer that spreads to nearby lymph nodes or other parts of the body. It is sometimes used in combination with targeted therapies. […] Targeted therapy for cancer is a treatment that uses medicines that attack specific chemicals in the cancer cells. […] Targeted therapy may be used for treating advanced ureteral cancer. […] After your treatment, your healthcare team may create a schedule of follow-up exams. During these exams, the team checks for signs that your cancer has returned. The team also looks for signs of bladder cancer, since people diagnosed with ureteral cancer have an increased risk of bladder cancer.

• #72 Renal Pelvis and Ureter Cancers – Kidney and Urinary Tract Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/kidney-and-urinary-tract-disorders/cancers-of-the-kidney-and-genitourinary-tract/renal-pelvis-and-ureter-cancers

  Occasionally, a medication, such as mitomycin C or bacille Calmette-Gurin (BCGa substance that stimulates the bodys immune system), is instilled into the ureter or a chemotherapy medication is given. […] A cystoscopy (insertion of a flexible viewing tube to examine the inside of the bladder) is done periodically after surgery, indefinitely, because people who have had this type of cancer are at risk of developing bladder cancer.

• #73 Ureteral cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ureteral-cancer/diagnosis-treatment/drc-20360722

  Targeted therapy may be used for treating advanced ureteral cancer. […] After your treatment, your healthcare team may create a schedule of follow-up exams. During these exams, the team checks for signs that your cancer has returned. The team also looks for signs of bladder cancer, since people diagnosed with ureteral cancer have an increased risk of bladder cancer.

• #74

  https://www.koruhastanesi.com/treatment-of-ureteral-tumors-319-55

  Of course, recurrence here and the emergence of a new recurrence in the bladder, especially after upper ureteral system tumors, can often be encountered in the bladder at a rate of up to 20-25%. In such cases, depending on the number of recurrences, the location of the recurrence and the size of the recurrent tumor, we also start intracavitary intra-bladder treatments if necessary. In this patient, we will probably start BCG treatment into the bladder after pathology.

• #75

  https://www.koruhastanesi.com/treatment-of-ureteral-tumors-319-55

  Of course, recurrence here and the emergence of a new recurrence in the bladder, especially after upper ureteral system tumors, can often be encountered in the bladder at a rate of up to 20-25%. In such cases, depending on the number of recurrences, the location of the recurrence and the size of the recurrent tumor, we also start intracavitary intra-bladder treatments if necessary. In this patient, we will probably start BCG treatment into the bladder after pathology.

• #76 Kidney-Sparing Treatment Options for Upper Tract Urothelial Carcinoma With and Without Lynch Syndrome | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/clinical-updates/kidney-sparing-treatment-options-for-upper-tract-urothelial-carcinoma-with-and-without-lynch-syndrome

  MSKs comprehensive program for patients with upper tract urothelial carcinoma (UTUC) offers kidney-sparing treatment options whenever possible. […] But the knee-jerk reaction to take out every kidney with a high-grade cancer doesnt always apply. MSK offers treatment options not available at other centers that are helping more patients with UTUC achieve better outcomes, including avoiding kidney removal and the worry about potentially needing dialysis. […] Our multidisciplinary team of medical oncologists and surgeons are collaborating to develop an individualized treatment strategy to provide him with a combination of organ-sparing surgery and effective drug therapies to target both tumor types based on genetic markers with the hope of achieving the best possible outcome. […] Last year, we reported the results of a retrospective study of our clinical experience at MSK supporting immune checkpoint inhibition as a neoadjuvant therapy or as an organ-sparing option for patients with Lynch syndrome. […] The split-dose approach was well tolerated and effective, with higher survival outcomes compared to historical series. […] At MSK, our focus is on helping patients avoid losing a kidney whenever possible.

• #77 Kidney-Sparing Treatment Options for Upper Tract Urothelial Carcinoma With and Without Lynch Syndrome | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/clinical-updates/kidney-sparing-treatment-options-for-upper-tract-urothelial-carcinoma-with-and-without-lynch-syndrome

  MSKs comprehensive program for patients with upper tract urothelial carcinoma (UTUC) offers kidney-sparing treatment options whenever possible. […] But the knee-jerk reaction to take out every kidney with a high-grade cancer doesnt always apply. MSK offers treatment options not available at other centers that are helping more patients with UTUC achieve better outcomes, including avoiding kidney removal and the worry about potentially needing dialysis. […] Our multidisciplinary team of medical oncologists and surgeons are collaborating to develop an individualized treatment strategy to provide him with a combination of organ-sparing surgery and effective drug therapies to target both tumor types based on genetic markers with the hope of achieving the best possible outcome. […] Last year, we reported the results of a retrospective study of our clinical experience at MSK supporting immune checkpoint inhibition as a neoadjuvant therapy or as an organ-sparing option for patients with Lynch syndrome. […] The split-dose approach was well tolerated and effective, with higher survival outcomes compared to historical series. […] At MSK, our focus is on helping patients avoid losing a kidney whenever possible.

• #78 New – Low Grade Upper Tract (Ureter/ Renal Pelvis) Treatment „Jelmyto” – American Bladder Cancer Society

  https://bladdercancersupport.org/discussion/new-low-grade-upper-tract-ureter-renal-pelvis-treatment-jelmyto/

  FDA Approves Jelmyto For UTUC […] April 15, 2020 Today, the U.S. Food and Drug Administration approved Jelmyto (mitomycin gel), the first therapy to treat low-grade upper tract urothelial cancer (UTUC). […] This is the first approval specifically for patients with low-grade UTUC and provides an option for some patients who may otherwise require a nephroureterectomy.

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

  https://uroweb.org/guidelines/upper-urinary-tract-urothelial-cell-carcinoma/chapter/disease-management

  Second-look URS after initial endoscopic treatment is recommended in the conservative management of UTUC to ensure complete tumour resection and evaluate residual disease. […] Percutaneous management can be considered for low-risk UTUC in the renal pelvis. […] Segmental or distal ureterectomy and ureteral resection with adequate margins, ideally based on frozen section analysis, provides sufficient pathological specimens for staging and grading while preserving the ipsilateral kidney. […] A single-arm phase III trial including 71 patients with biopsy-proven low-grade UTUC measuring less than 15 mm showed that the use of mitomycin-containing reverse thermal gel (UGN-101) instillations (6 weekly induction) in a chemoablation setting via retrograde catheter to the renal pelvis and calyces was associated with a complete response rate in a total of 41 patients (58%).

• #80 Kidney-Sparing Treatment Options for Upper Tract Urothelial Carcinoma With and Without Lynch Syndrome | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/clinical-updates/kidney-sparing-treatment-options-for-upper-tract-urothelial-carcinoma-with-and-without-lynch-syndrome

  MSKs comprehensive program for patients with upper tract urothelial carcinoma (UTUC) offers kidney-sparing treatment options whenever possible. […] But the knee-jerk reaction to take out every kidney with a high-grade cancer doesnt always apply. MSK offers treatment options not available at other centers that are helping more patients with UTUC achieve better outcomes, including avoiding kidney removal and the worry about potentially needing dialysis. […] Our multidisciplinary team of medical oncologists and surgeons are collaborating to develop an individualized treatment strategy to provide him with a combination of organ-sparing surgery and effective drug therapies to target both tumor types based on genetic markers with the hope of achieving the best possible outcome. […] Last year, we reported the results of a retrospective study of our clinical experience at MSK supporting immune checkpoint inhibition as a neoadjuvant therapy or as an organ-sparing option for patients with Lynch syndrome. […] The split-dose approach was well tolerated and effective, with higher survival outcomes compared to historical series. […] At MSK, our focus is on helping patients avoid losing a kidney whenever possible.

• #81 Kidney-Sparing Treatment Options for Upper Tract Urothelial Carcinoma With and Without Lynch Syndrome | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/clinical-updates/kidney-sparing-treatment-options-for-upper-tract-urothelial-carcinoma-with-and-without-lynch-syndrome

  MSKs comprehensive program for patients with upper tract urothelial carcinoma (UTUC) offers kidney-sparing treatment options whenever possible. […] But the knee-jerk reaction to take out every kidney with a high-grade cancer doesnt always apply. MSK offers treatment options not available at other centers that are helping more patients with UTUC achieve better outcomes, including avoiding kidney removal and the worry about potentially needing dialysis. […] Our multidisciplinary team of medical oncologists and surgeons are collaborating to develop an individualized treatment strategy to provide him with a combination of organ-sparing surgery and effective drug therapies to target both tumor types based on genetic markers with the hope of achieving the best possible outcome. […] Last year, we reported the results of a retrospective study of our clinical experience at MSK supporting immune checkpoint inhibition as a neoadjuvant therapy or as an organ-sparing option for patients with Lynch syndrome. […] The split-dose approach was well tolerated and effective, with higher survival outcomes compared to historical series. […] At MSK, our focus is on helping patients avoid losing a kidney whenever possible.

• #82 Urothelial Tumors of the Renal Pelvis and Ureters Guidelines: Guidelines Summary

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

  Discuss adjuvant nivolumab with patients who are unfit for, or who declined, platinum-based adjuvant chemotherapy for pT3 and/or pN+ disease after RNU alone or ypT2 and/or ypN+ disease after neoadjuvant chemotherapy, followed by RNU. […] Offer the checkpoint inhibitors pembrolizumab or atezolizumab to patients with programmed death ligand 1 (PD-L1)positive tumors. […] Offer enfortumab vedotin to patients previously treated with platinum-containing chemotherapy and who had disease progression during or after treatment with a PD-1 or PD-L1 inhibitor. […] Offer erdafitinib as subsequent-line therapy to patients with platinum-refractory UTUC with FGFR DNA genomic alterations (FGFR2/3 mutations or FGFR3 fusions).

• #83 Kidney-Sparing Treatment Options for Upper Tract Urothelial Carcinoma With and Without Lynch Syndrome | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/clinical-updates/kidney-sparing-treatment-options-for-upper-tract-urothelial-carcinoma-with-and-without-lynch-syndrome

  MSKs comprehensive program for patients with upper tract urothelial carcinoma (UTUC) offers kidney-sparing treatment options whenever possible. […] But the knee-jerk reaction to take out every kidney with a high-grade cancer doesnt always apply. MSK offers treatment options not available at other centers that are helping more patients with UTUC achieve better outcomes, including avoiding kidney removal and the worry about potentially needing dialysis. […] Our multidisciplinary team of medical oncologists and surgeons are collaborating to develop an individualized treatment strategy to provide him with a combination of organ-sparing surgery and effective drug therapies to target both tumor types based on genetic markers with the hope of achieving the best possible outcome. […] Last year, we reported the results of a retrospective study of our clinical experience at MSK supporting immune checkpoint inhibition as a neoadjuvant therapy or as an organ-sparing option for patients with Lynch syndrome. […] The split-dose approach was well tolerated and effective, with higher survival outcomes compared to historical series. […] At MSK, our focus is on helping patients avoid losing a kidney whenever possible.

• #84 Kidney-Sparing Treatment Options for Upper Tract Urothelial Carcinoma With and Without Lynch Syndrome | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/clinical-updates/kidney-sparing-treatment-options-for-upper-tract-urothelial-carcinoma-with-and-without-lynch-syndrome

  MSKs comprehensive program for patients with upper tract urothelial carcinoma (UTUC) offers kidney-sparing treatment options whenever possible. […] But the knee-jerk reaction to take out every kidney with a high-grade cancer doesnt always apply. MSK offers treatment options not available at other centers that are helping more patients with UTUC achieve better outcomes, including avoiding kidney removal and the worry about potentially needing dialysis. […] Our multidisciplinary team of medical oncologists and surgeons are collaborating to develop an individualized treatment strategy to provide him with a combination of organ-sparing surgery and effective drug therapies to target both tumor types based on genetic markers with the hope of achieving the best possible outcome. […] Last year, we reported the results of a retrospective study of our clinical experience at MSK supporting immune checkpoint inhibition as a neoadjuvant therapy or as an organ-sparing option for patients with Lynch syndrome. […] The split-dose approach was well tolerated and effective, with higher survival outcomes compared to historical series. […] At MSK, our focus is on helping patients avoid losing a kidney whenever possible.

• #85 Uretral Cancer Treatment | Fox Chase Cancer Center – Philadelphia PA

  https://www.foxchase.org/clinical-care/conditions/ureteral-cancer/treatment

  At Fox Chase Cancer Center, our multidisciplinary medical team works closely to accurately diagnose your ureteral cancer and help you understand your options so that you can make an informed decision about your treatment. […] As a regional and national leader in cancer care, Fox Chase has a wealth of experience treating all types of ureteral cancer. […] Our skilled, multispecialty genitourinary cancer team meets regularly to review patient cases and map out a personalized treatment plan. We strive to treat your cancer in the least invasive way possible using innovative surgical techniques and combination therapies that give you the best chance of a successful outcome. […] Our doctors are also actively involved in developing new therapies for treating ureteral cancer. Through clinical trials, we are able to offer our patients access to promising treatments and experimental therapies that may not be available elsewhere. Ask your Fox Chase doctor if a clinical trial is right for you.

• #86 Ureteral cancer – Care at Mayo Clinic – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ureteral-cancer/care-at-mayo-clinic/mac-20360724

  Laparoscopic surgery involves making several small cuts in your stomach area. Specialized surgical tools, including a camera, are inserted through the cuts and used to perform the surgery. […] Robotic surgery is a type of laparoscopic surgery in which the surgical tools are moved by a robot that’s controlled by the surgeon. Robotic surgery allows for more-precise movements in tight spaces. […] Mayo Clinic urologists are respected for their experience and expertise in diagnosing and treating ureteral cancer. At Mayo Clinic, you can expect personalized treatment. At Mayo Clinic, urologists work with oncologists, radiologists and pathologists, to create a personalized treatment plan. The personalized treatment plan takes into consideration all your needs. […] Each year, Mayo Clinic doctors care for many people with ureteral cancer. This experience with rare cancers means your care team is prepared with knowledge and resources to provide you with exactly the care you need. […] Mayo Clinic Comprehensive Cancer Center meets the strict standards for a National Cancer Institute-Designated Comprehensive Cancer Center. These standards recognize scientific excellence and a multispecialty approach focused on cancer prevention, diagnosis and treatment.

• #87 Upper urinary tract urothelial cancer | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/upper-urinary-tract-urothelial-cancer-UTUC

  A team of specialists will discuss your treatment options. This is called a multidisciplinary team (MDT). […] Treatment depends on a number of factors, including the position, type, stage and grade of the cancer. Your doctors will also consider: how well your kidneys work, your general health, your personal preferences. […] Your cancer doctor will explain the different treatments and their side effects. They will also talk to you about the things you should consider when making treatment decisions. […] You may also have some treatments as part of a clinical trial. […] Surgery aims to remove the area affected by cancer. It is usually the main treatment for UTUC that has not spread to distant parts of the body. After surgery, you may be offered other treatments to try and get rid of any remaining cancer cells. This may reduce the chance of the cancer coming back. This is called adjuvant treatment.

• #88 Ureter Cancer | Cancer | Loyola Medicine

  https://www.loyolamedicine.org/services/cancer/cancer-conditions/ureter-cancer

  Ureter cancer, also referred to as urinary tract cancer, is a rare form of cancer that is treated by the highly skilled doctors at Loyola Medicine. […] Treatment for ureter cancer is specific to each individual person. Your treatment will depend on the size and stage of your cancer, as well as the part of the urethra that is affected. At Loyola, an interdisciplinary team of doctors works together to develop the most comprehensive cancer treatment plan that will result in the best outcome for you. The four primary treatments for ureter cancer are: Active surveillance, Chemotherapy, Radiation therapy, Surgery. […] Our doctors most commonly manage ureter cancer surgically, by removing the entire or a portion of the ureter and a kidney. We use endoscopic management to treat ureter cancer, which involves inserting a tube with cameras through the kidney.

• #89 Transitional Cell Cancer of the Renal Pelvis and Ureter > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/transitional-cell-cancer-of-the-renal-pelvis-and-ureter

  A cancer that begins in cells in the renal pelvis and ureter, which are part of the upper urinary tract. […] Treatment includes surgery, chemotherapy, radiation, targeted therapy. […] The good news is that when transitional cell cancer of the renal pelvis and ureter is caught early, its very treatable. […] We now have a large number of treatments, ranging from surgery to immune therapies to chemotherapies, including combinations. […] Surgery is usually recommended as a first-line treatment to remove the affected kidney, renal pelvis, ureter, and bladder cuff (where the ureter connects to the bladder). […] After surgery, patients may undergo chemotherapy to help prevent cancer from developing in the bladder. […] For patients who cannot tolerate surgery, radiation plus chemotherapy is a standard-of-care treatment.

• #90 Get Urethral Cancer Treatment | Cleveland Clinic

  https://my.clevelandclinic.org/services/urethral-cancer-treatment

  After all of this testing, well look at the results and make a diagnosis. We do all of this as quickly as possible so we can start planning your urethral cancer treatment. […] Well craft your personalized treatment plan by looking at a few different things like your age, lifestyle and details about your cancer, like its type, size and if it has spread. […] Surgery is the most common treatment for urethral cancer. […] If your urethral cancer has spread to other areas of your body, you might need more complex surgery. […] Other treatments for urethral cancer may include chemotherapy or immunotherapy. Or you might also have radiation therapy, which can shrink tumors and kill cancer cells. […] If weve removed your urethra, penis or vagina as part of your treatment, you might decide to have reconstructive surgery. […] A urethral cancer diagnosis can leave you feeling overwhelmed, stressed and worried about whats next. Its natural. But you dont have to go through your cancer journey alone. Cleveland Clinic healthcare providers will be with you every step of the way.

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