Urothelial carcinoma of the ureter Flashcards
Workup?
Imaging of the upper tract collecting system
CYTOLOGY
CYSTOSCOPY
URETEROSCOPY AND BIOPSY AND/OR SELECTIVE WASHINGS
RENAL FUNCTION TESTS
NUCLEAR MEDICINE RENAL SCAN
CXR
CBC, CHEM PROFILE
BONE SCAN AS NEEDED
FAMILY HISTORY
Primary treatment is dependent on?
LOCATION
For upper urothelial carcinoma of the ureter, what are the TWO primary treatment options?
NEPHROURETERECTOMY WITH BLADDER CUFF WITH REGIONAL LYMPHADENECTOMY IF HIGH GRADE AND CONSIDER NEOADJUVANT CHEMOTHERAPY
OR
ENDOSCOPIC RESECTION
For upper urothelial carcinoma of the ureter that is high grade, what is the additional surgical procedure to be added to the primary treatment option?
REGIONAL LYMPHADENECTOMY
For upper urothelial carcinoma of the ureter, is neoadjuvant chemotherapy an option?
YES
In urothelial carcinoma of the ureter, after endoscopic resection, what can be applied post op?
MITOMYCIN URETERAL GEL
In middle low grade urothelial carcinoma of the ureter, aside from endoscopic resection and nephroureterectomy with cuff of bladder, what is another option in highly selected patients?
EXCISION AND URETEROURETEROSTOMY/ILEAL URETER
In middle HIGH GRADE urothelial carcinoma of the ureter, what is the ONLY OPTION?
NEPHROURETERECTOMY WITH BLADDER CUFF AND REGIONAL LYMPHADENECTOMY AND CONSIDER NEOADJUVANT CHEMOTHERAPY
What is the surgical option exclusive for low grade lesions in DISTAL urothelial carcinoma of the ureter?
ENDOSCOPIC RESECTION
In distal lesions, what are the two major procedures that you can offer to patients?
NEPHROURETERECTOMY WITH BLADDER CUFF AND REGIONAL LYMPHADENECTOMY IF HIGH GRADE
CONSIDER NEOADJUVANT CHEMOTHERAPY
OR
DISTAL URETERECTOMY AND REGIONAL LYMPHADENECTOMY IF HIGH GRADE AND REIMPLANTATION OF URETER, CONSIDER NEOADJUVANT CHEMO
METASTATIC TUMORS?
SYSTEMIC THERAPY
