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Urinary - Conditions > Urothelial Carcinoma > Flashcards

Urothelial Carcinoma Flashcards

1
Q

another name for urothelial carcinoma

A

transistional cell carcinoma

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2
Q

investigations of frank haematuria

A

flexible cystourethroscopy, CT, USS

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3
Q

investigations of dipstick or microscopic haematuria

A

flexible cystourethroscopy and USS, but needed less urgently than in frank haematuria

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4
Q

risk of malignancy in over 50 y/o with dipstick or microscopic haematuria

A

5-10%

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5
Q

which type of haematuria has a greater risk of malignancy in over 50 y/o

A

frank

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6
Q

what is the most common neoplastic cause of haematuria

A

bladder TCC

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7
Q

what is an IVU

A

an intravenous urogram (aka intravenous pyelogram). injected with special contrast to show up kidneys and tract on an X-ray

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8
Q

problem with IVU and USS for diagnosing TCC

A

they miss a proportion of tumours

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9
Q

what risk factor is present in 40% of bladder TCC

A

smoking

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10
Q

risk factors of bladder TCC

A

smoking, aromatic amines?and non-hereditary genetic mutations in p53 and Rb

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11
Q

what parasite is a risk factor for squamous cell bladder cancer

A

schistosomiasis haematobium

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12
Q

what is cyclophosphamide therapy

A

chemotherapy

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13
Q

risk factors for squamous cell carcinoma

A 
schistomiasis
chronic cystitis
chyclophosphamide
pelvic radiotherapy
adenocarcinoma
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14
Q

presentation of bladder cancer

A 
haematuria (frank or microscopic)
recurrent UTI
storage LUTS
bladder pain
metastatic symptoms
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15
Q

investigations when presentation is haematuria

A

urine culture, urine cytology, cystourethroscopy and CTU/USS

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16
Q

what is CIS

A

carcinoma in situ: a very aggressive non-invasive tumour

17
Q

what T grade is a tumour in the mucosal layer of the bladder

A

T1

18
Q

what grades represent a tumour that has invaded the muscle wall and no further

A

stages 2 and 3

19
Q

where does a T4 bladder TCC tumour invade to

A

outside bladder: prostate, vagina, uterus

20
Q

what does M1 mean

A

the tumour has distant metastases

21
Q

what does N0 mean

A

no lymph node spread

22
Q

what does N1 mean

A

one regional lymph node spread

23
Q

what does N2 mean

A

multiple lymph node spread in pelivs

24
Q

risk of bladder TCC in frank haematuria in >50y/o

A

25-35%

25
Q

what proportion of TCC are bladder

A

90%

26
Q

treatment in T1 bladder TCC

A

endoscopic resection + intravesical chemo –> endoscopic check up –> further course of chemo

27
Q

treatment in T2 bladder TCC

A

bacillus calmette-guerin chemo weekly –> radical cystectomy if refractory to BCG

28
Q

treatment in T2-T3 bladder TCC

A

neoadjuvant chemo followed by –> radical radiotherapy
OR
–> radical cystectomy (with prostate in men/with urethra in women)

29
Q

5 year survival for invasive high grade bladder TCC

A

50%

30
Q

5 year survival for non-invasive low grade bladder TCC

A

90%

31
Q

what is UTUC

A

upper tract urothelial carcinoma

32
Q

where does UTUC most commonly occur

A

in the collecting system or renal pelvis

33
Q

mainstay of treatment in high grade UTUC

A

nephro-ureterectomy

34
Q

why is an endoscopic resection no use in high grade UTUC

A

because there is a high recurrence rate

35
Q

presentation of UTUC

A

frank haematuria, flank pain, symptoms of metastases, unilateral ureteric obstruction

36
Q

4 investigations to order in UTUC

A

CT-IVU/IVU
urine cytology
ureteroscopy
biopsy

37
Q

what is the main prognostic risk of UTUC

A

developing bladder TCC (40% in 10 years)

38
Q

what differs between presentation of bladder TCC and UTUC

A

bladder has recurrent UTIs and storage LUTS; UTUC does not

symptoms of UTUC present unilaterally i.e flank pain; bladder does not

Urinary - Conditions (13 decks)

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