6.2. Cancer - Upper Tract Urothelial Cancer Flashcards
Where are Upper Tract Urothelial Cancer most commonly found?
- The Renal Pelvis
2. The Collecting System
How are the tumours often described?
- High Grade
- Multifocal
- Unilateral - low risk of Contralateral involvement
What are the Clinical Features of Upper Tract Urothelial Cancer?
- Frank Haematuria
- Unilateral Ureteric Obstruction
- Flank / Loin Pain
- Nodal / Metastatic Symptoms
What are some examples of Nodal / Metastatic Symptoms?
- Bone Pain
- Hyperglycaemia
- Lung Carcinoma Symptoms
- Brain Cancer Symptoms
What investigations are necessary for Upper Tract Urothelial Cancer?
- A CT-Intravenous Urogram (CT-IVU)
- Urine Cytology
- Uretoscopy
- Biopsy
- CT Chest / Abdomen
What is the function of a CT-Intravenous Urogram (CT-IVU)?
This will show filling defects of the renal pelvis
What is the function of Urine Cytology?
- Looking for tumour effects in the Urine
2. Looking for Haematuria
What is the function of a Ureteroscopy?
To view the lesion
What is the purpose of Biopsy?
Staging and Grading
What are the treatment options for Upper Tract Urothelial Cancer?
- Nephro-Ureterectomy
- Ureteroscopic Laser Ablation
- Ureteroscopic Stenting
What is the risk associated with Nephro-Ureterectomy?
High rate of recurrence
When will a Ureteroscopic Laser Ablation be used?
If the patient is unfit for Nephro-Ureterectomy
What is the advantage / disadvantage of Ureteroscopic Laser Ablation?
Advantage - This is a Nephron sparing endoscopic treatment
Disadvantage - Required regular surveillance by Ureteroscopy
What is there a high risk of in Upper Tract Urothelial Cancer?
Synchronous and Metachronous Bladder Carcinoma
