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Erschienen in: Die Onkologie 9/2022

25.07.2022 | Urothelkarzinom | Leitthema

Urothelkarzinom des oberen Harntraktes: aktuelle Behandlungsstrategien

verfasst von: Maria Marx, Laura-Maria Krabbe, Felix Wezel, Jan-Thorsten Klein, Friedemann Zengerling, Prof. Dr. med. Christian Bolenz

Erschienen in: Die Onkologie | Ausgabe 9/2022

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Zusammenfassung

Hintergrund

Das Therapiespektrum des Urothelkarzinoms des oberen Harntraktes ist breit und hängt maßgeblich von der individuellen Risikokonstellation ab. Eine möglichst exakte Diagnosestellung und Ausbreitungsdiagnostik sind unabdingbar für die Einordnung in die Niedrig- bzw. Hochrisikogruppe (low-risk bzw. high-risk).

Ziel

Darstellung der weiterentwickelten Diagnostik- und Therapiemöglichkeiten sowie der differenzierten Behandlungsstrategien des lokal begrenzten Urothelkarzinoms des oberen Harntrakts.

Material und Methoden

Selektive Literaturrecherche in der Datenbank PubMed zu den Themen Urothelkarzinom des oberen Harntrakts, Diagnostik, organerhaltende Therapie, radikale Nephroureterektomie sowie multimodale Therapiekonzepte.

Ergebnisse

Die Fortschritte bei der Bildgebung und den endoskopischen Techniken haben die diagnostische Sicherheit für das Urothelkarzinom des oberen Harntraktes erhöht und das Understaging reduziert. Die möglichst akkurate Einordnung in die Hoch- oder Niedrigrisikogruppe vereinfacht eine Therapieentscheidung. Nierenerhaltende Verfahren, z. B. eine endoskopische lasergestützte Tumorablation oder eine Uretersegmentresektion, können in bestimmten Konstellationen eingesetzt werden. Die radikale Nephroureterektomie ist der Goldstandard bei high-risk Karzinomen aufgrund des hohen Risikos für eine Progression und Metastasierung. Bei einem klinischen Tumorstadium ≥cT3 wird ein offener Zugang gegenüber einer laparoskopischen Vorgehensweise favorisiert. Eine adjuvante platinhaltige Chemotherapie soll nach der radikalen Nephroureterektomie bei einem pathologischen Tumorstadium ≥pT2 und/oder pN+ durchgeführt werden.

Diskussion

Mittlerweile bieten neue Algorithmen die Möglichkeit, therapieinduzierte Morbidität zu reduzieren und das onkologische Outcome zu verbessern, v. a. durch effektivere Multimodalkonzepte.
Literatur
2.
Zurück zum Zitat Rouprêt M et al (2021) European association of urology guidelines on upper urinary tract urothelial carcinoma: 2020 update. Eur Urol 79(1):62–79 PubMedCrossRef Rouprêt M et al (2021) European association of urology guidelines on upper urinary tract urothelial carcinoma: 2020 update. Eur Urol 79(1):62–79 PubMedCrossRef
3.
Zurück zum Zitat System, E.-E.C.I (2022) Incidence and mortality statistics, by registry and cancer site System, E.-E.C.I (2022) Incidence and mortality statistics, by registry and cancer site
4.
Zurück zum Zitat Robert-Koch-Institut, Z.f.K.i. (2021) Datenbankabfrage mit Schätzung der Inzidenz, Prävalenz und des Überlebens von Krebs in Deutschland auf Basis der epidemiologischen Landeskrebsregisterdaten Robert-Koch-Institut, Z.f.K.i. (2021) Datenbankabfrage mit Schätzung der Inzidenz, Prävalenz und des Überlebens von Krebs in Deutschland auf Basis der epidemiologischen Landeskrebsregisterdaten
6.
7.
Zurück zum Zitat Green DA et al (2013) Urothelial carcinoma of the bladder and the upper tract: disparate twins. J Urol 189(4):1214–1221 PubMedCrossRef Green DA et al (2013) Urothelial carcinoma of the bladder and the upper tract: disparate twins. J Urol 189(4):1214–1221 PubMedCrossRef
8.
Zurück zum Zitat Margulis V et al (2009) Outcomes of radical nephroureterectomy: a series from the upper tract urothelial carcinoma collaboration. Cancer 115(6):1224–1233 PubMedCrossRef Margulis V et al (2009) Outcomes of radical nephroureterectomy: a series from the upper tract urothelial carcinoma collaboration. Cancer 115(6):1224–1233 PubMedCrossRef
9.
Zurück zum Zitat Brown GA et al (2006) Nephroureterectomy for treating upper urinary tract transitional cell carcinoma: time to change the treatment paradigm? BJU Int 98(6):1176–1180 PubMedCrossRef Brown GA et al (2006) Nephroureterectomy for treating upper urinary tract transitional cell carcinoma: time to change the treatment paradigm? BJU Int 98(6):1176–1180 PubMedCrossRef
10.
Zurück zum Zitat Birtle A et al (2020) Adjuvant chemotherapy in upper tract urothelial carcinoma (the POUT trial): a phase 3, open-label, randomised controlled trial. Lancet 395(10232):1268–1277 PubMedPubMedCentralCrossRef Birtle A et al (2020) Adjuvant chemotherapy in upper tract urothelial carcinoma (the POUT trial): a phase 3, open-label, randomised controlled trial. Lancet 395(10232):1268–1277 PubMedPubMedCentralCrossRef
11.
Zurück zum Zitat Lughezzani G et al (2012) Prognostic factors in upper urinary tract urothelial carcinomas: a comprehensive review of the current literature. Eur Urol 62(1):100–114 PubMedCrossRef Lughezzani G et al (2012) Prognostic factors in upper urinary tract urothelial carcinomas: a comprehensive review of the current literature. Eur Urol 62(1):100–114 PubMedCrossRef
12.
Zurück zum Zitat Matsumoto K et al (2011) Racial differences in the outcome of patients with urothelial carcinoma of the upper urinary tract: an international study. BJU Int 108(8 Pt 2):E304–E309 PubMedCrossRef Matsumoto K et al (2011) Racial differences in the outcome of patients with urothelial carcinoma of the upper urinary tract: an international study. BJU Int 108(8 Pt 2):E304–E309 PubMedCrossRef
13.
Zurück zum Zitat Rink M et al (2013) Impact of smoking on oncologic outcomes of upper tract urothelial carcinoma after radical nephroureterectomy. Eur Urol 63(6):1082–1090 PubMedCrossRef Rink M et al (2013) Impact of smoking on oncologic outcomes of upper tract urothelial carcinoma after radical nephroureterectomy. Eur Urol 63(6):1082–1090 PubMedCrossRef
14.
Zurück zum Zitat Simsir A et al (2011) Prognostic factors for upper urinary tract urothelial carcinomas: stage, grade, and smoking status. Int Urol Nephrol 43(4):1039–1045 PubMedCrossRef Simsir A et al (2011) Prognostic factors for upper urinary tract urothelial carcinomas: stage, grade, and smoking status. Int Urol Nephrol 43(4):1039–1045 PubMedCrossRef
15.
Zurück zum Zitat Carrion A et al (2016) Intraoperative prognostic factors and atypical patterns of recurrence in patients with upper urinary tract urothelial carcinoma treated with laparoscopic radical nephroureterectomy. Scand J Urol 50(4):305–312 PubMedCrossRef Carrion A et al (2016) Intraoperative prognostic factors and atypical patterns of recurrence in patients with upper urinary tract urothelial carcinoma treated with laparoscopic radical nephroureterectomy. Scand J Urol 50(4):305–312 PubMedCrossRef
16.
Zurück zum Zitat Ehdaie B et al (2011) Obesity adversely impacts disease specific outcomes in patients with upper tract urothelial carcinoma. J Urol 186(1):66–72 PubMedPubMedCentralCrossRef Ehdaie B et al (2011) Obesity adversely impacts disease specific outcomes in patients with upper tract urothelial carcinoma. J Urol 186(1):66–72 PubMedPubMedCentralCrossRef
17.
Zurück zum Zitat Rouprêt M et al (2012) Genetic variability in 8q24 confers susceptibility to urothelial carcinoma of the upper urinary tract and is linked with patterns of disease aggressiveness at diagnosis. J Urol 187(2):424–428 PubMedCrossRef Rouprêt M et al (2012) Genetic variability in 8q24 confers susceptibility to urothelial carcinoma of the upper urinary tract and is linked with patterns of disease aggressiveness at diagnosis. J Urol 187(2):424–428 PubMedCrossRef
18.
Zurück zum Zitat Xia L et al (2018) Impact of surgical waiting time on survival in patients with upper tract urothelial carcinoma: a national cancer database study. Urol Oncol 36(1):10.e15–10.e22 CrossRef Xia L et al (2018) Impact of surgical waiting time on survival in patients with upper tract urothelial carcinoma: a national cancer database study. Urol Oncol 36(1):10.e15–10.e22 CrossRef
19.
Zurück zum Zitat Nishiyama N et al (2018) Upper tract urothelial carcinoma following intravesical bacillus Calmette-Guérin therapy for nonmuscle-invasive bladder cancer: Results from a multi-institutional retrospective study. Urol Oncol 36(6):306.e9–306.e15 CrossRef Nishiyama N et al (2018) Upper tract urothelial carcinoma following intravesical bacillus Calmette-Guérin therapy for nonmuscle-invasive bladder cancer: Results from a multi-institutional retrospective study. Urol Oncol 36(6):306.e9–306.e15 CrossRef
20.
Zurück zum Zitat Messer JC et al (2013) Multi-institutional validation of the ability of preoperative hydronephrosis to predict advanced pathologic tumor stage in upper-tract urothelial carcinoma. Urol Oncol 31(6):904–908 PubMedCrossRef Messer JC et al (2013) Multi-institutional validation of the ability of preoperative hydronephrosis to predict advanced pathologic tumor stage in upper-tract urothelial carcinoma. Urol Oncol 31(6):904–908 PubMedCrossRef
21.
Zurück zum Zitat Janisch F et al (2020) Diagnostic performance of multidetector computed tomographic (MDCTU) in upper tract urothelial carcinoma (UTUC): a systematic review and meta-analysis. World J Urol 38(5):1165–1175 PubMedCrossRef Janisch F et al (2020) Diagnostic performance of multidetector computed tomographic (MDCTU) in upper tract urothelial carcinoma (UTUC): a systematic review and meta-analysis. World J Urol 38(5):1165–1175 PubMedCrossRef
22.
Zurück zum Zitat Takahashi N et al (2010) Gadolinium enhanced magnetic resonance urography for upper urinary tract malignancy. J Urol 183(4):1330–1365 PubMedCrossRef Takahashi N et al (2010) Gadolinium enhanced magnetic resonance urography for upper urinary tract malignancy. J Urol 183(4):1330–1365 PubMedCrossRef
23.
Zurück zum Zitat Malm C et al (2017) Diagnostic accuracy of upper tract urothelial carcinoma: how samples are collected matters. Scand J Urol 51(2):137–145 PubMedCrossRef Malm C et al (2017) Diagnostic accuracy of upper tract urothelial carcinoma: how samples are collected matters. Scand J Urol 51(2):137–145 PubMedCrossRef
24.
Zurück zum Zitat Koll FJ et al (2021) Evaluation of pre-operative biopsy, surgical procedures and oncologic outcomes in upper tract urothelial carcinoma (UTUC). Front Surg 8:790738 PubMedPubMedCentralCrossRef Koll FJ et al (2021) Evaluation of pre-operative biopsy, surgical procedures and oncologic outcomes in upper tract urothelial carcinoma (UTUC). Front Surg 8:790738 PubMedPubMedCentralCrossRef
25.
Zurück zum Zitat Ritter M et al (2013) Standardized ex vivo comparison of different upper urinary tract biopsy devices: impact on ureterorenoscopes and tissue quality. World J Urol 31(4):907–912 PubMedCrossRef Ritter M et al (2013) Standardized ex vivo comparison of different upper urinary tract biopsy devices: impact on ureterorenoscopes and tissue quality. World J Urol 31(4):907–912 PubMedCrossRef
26.
Zurück zum Zitat Foerster B et al (2019) Biopsy techniques in the upper urinary tract for the diagnosis of urothelial carcinoma: systematic review. Urologe A 58(1):14–21 PubMedCrossRef Foerster B et al (2019) Biopsy techniques in the upper urinary tract for the diagnosis of urothelial carcinoma: systematic review. Urologe A 58(1):14–21 PubMedCrossRef
27.
Zurück zum Zitat Klein JT et al (2019) Cryobiopsy in the upper urinary tract: preclinical evaluation of a novel device. Urology 123:273–279 PubMedCrossRef Klein JT et al (2019) Cryobiopsy in the upper urinary tract: preclinical evaluation of a novel device. Urology 123:273–279 PubMedCrossRef
28.
Zurück zum Zitat Kriegmair MC et al (2021) Enhanced imaging in urological endoscopy. Urologe A 60(1):8–18 PubMedCrossRef Kriegmair MC et al (2021) Enhanced imaging in urological endoscopy. Urologe A 60(1):8–18 PubMedCrossRef
29.
Zurück zum Zitat Bus MT et al (2016) Optical coherence tomography as a tool for in vivo staging and grading of upper urinary tract urothelial carcinoma: a study of diagnostic accuracy. J Urol 196(6):1749–1755 PubMedCrossRef Bus MT et al (2016) Optical coherence tomography as a tool for in vivo staging and grading of upper urinary tract urothelial carcinoma: a study of diagnostic accuracy. J Urol 196(6):1749–1755 PubMedCrossRef
30.
Zurück zum Zitat Sonn GA et al (2009) Optical biopsy of human bladder neoplasia with in vivo confocal laser endomicroscopy. J Urol 182(4):1299–1305 PubMedCrossRef Sonn GA et al (2009) Optical biopsy of human bladder neoplasia with in vivo confocal laser endomicroscopy. J Urol 182(4):1299–1305 PubMedCrossRef
32.
Zurück zum Zitat Seisen T, Colin P, Rouprêt M (2015) Risk-adapted strategy for the kidney-sparing management of upper tract tumours. Nat Rev Urol 12(3):155–166 PubMedCrossRef Seisen T, Colin P, Rouprêt M (2015) Risk-adapted strategy for the kidney-sparing management of upper tract tumours. Nat Rev Urol 12(3):155–166 PubMedCrossRef
33.
Zurück zum Zitat Rouprêt M, Colin P, Yates DR (2014) A new proposal to risk stratify urothelial carcinomas of the upper urinary tract (UTUCs) in a predefinitive treatment setting: low-risk versus high-risk UTUCs. Eur Urol 66(2):181–183 PubMedCrossRef Rouprêt M, Colin P, Yates DR (2014) A new proposal to risk stratify urothelial carcinomas of the upper urinary tract (UTUCs) in a predefinitive treatment setting: low-risk versus high-risk UTUCs. Eur Urol 66(2):181–183 PubMedCrossRef
34.
Zurück zum Zitat Margulis V et al (2010) Preoperative multivariable prognostic model for prediction of nonorgan confined urothelial carcinoma of the upper urinary tract. J Urol 184(2):453–458 PubMedCrossRef Margulis V et al (2010) Preoperative multivariable prognostic model for prediction of nonorgan confined urothelial carcinoma of the upper urinary tract. J Urol 184(2):453–458 PubMedCrossRef
35.
Zurück zum Zitat Seisen T et al (2016) Oncologic outcomes of kidney-sparing surgery versus radical nephroureterectomy for upper tract urothelial carcinoma: a systematic review by the EAU non-muscle invasive bladder cancer guidelines panel. Eur Urol 70(6):1052–1068 PubMedCrossRef Seisen T et al (2016) Oncologic outcomes of kidney-sparing surgery versus radical nephroureterectomy for upper tract urothelial carcinoma: a systematic review by the EAU non-muscle invasive bladder cancer guidelines panel. Eur Urol 70(6):1052–1068 PubMedCrossRef
37.
Zurück zum Zitat Grasso M et al (2012) Ureteroscopic and extirpative treatment of upper urinary tract urothelial carcinoma: a 15-year comprehensive review of 160 consecutive patients. BJU Int 110(11):1618–1626 PubMedCrossRef Grasso M et al (2012) Ureteroscopic and extirpative treatment of upper urinary tract urothelial carcinoma: a 15-year comprehensive review of 160 consecutive patients. BJU Int 110(11):1618–1626 PubMedCrossRef
38.
Zurück zum Zitat Vemana G et al (2016) Survival comparison between endoscopic and surgical management for patients with upper tract urothelial cancer: a matched propensity score analysis using surveillance, epidemiology and end results-medicare data. Urology 95:115–120 PubMedCrossRef Vemana G et al (2016) Survival comparison between endoscopic and surgical management for patients with upper tract urothelial cancer: a matched propensity score analysis using surveillance, epidemiology and end results-medicare data. Urology 95:115–120 PubMedCrossRef
39.
Zurück zum Zitat Fang D et al (2016) A systematic review and meta-analysis of oncological and renal function outcomes obtained after segmental ureterectomy versus radical nephroureterectomy for upper tract urothelial carcinoma. Eur J Surg Oncol 42(11):1625–1635 PubMedPubMedCentralCrossRef Fang D et al (2016) A systematic review and meta-analysis of oncological and renal function outcomes obtained after segmental ureterectomy versus radical nephroureterectomy for upper tract urothelial carcinoma. Eur J Surg Oncol 42(11):1625–1635 PubMedPubMedCentralCrossRef
40.
Zurück zum Zitat Azizi M et al (2019) Optimal management of upper tract urothelial carcinoma: an unmet need. Curr Treat Options Oncol 20(5):40 PubMedCrossRef Azizi M et al (2019) Optimal management of upper tract urothelial carcinoma: an unmet need. Curr Treat Options Oncol 20(5):40 PubMedCrossRef
41.
Zurück zum Zitat Piraino JA et al (2020) Nephroureterectomy vs. segmental ureterectomy of clinically localized, high-grade, urothelial carcinoma of the ureter: practice patterns and outcomes. Urol Oncol 38(11):851.e1–851.e10 CrossRef Piraino JA et al (2020) Nephroureterectomy vs. segmental ureterectomy of clinically localized, high-grade, urothelial carcinoma of the ureter: practice patterns and outcomes. Urol Oncol 38(11):851.e1–851.e10 CrossRef
42.
Zurück zum Zitat Bagrodia A et al (2013) Comparative analysis of oncologic outcomes of partial ureterectomy vs radical nephroureterectomy in upper tract urothelial carcinoma. Urology 81(5):972–977 PubMedCrossRef Bagrodia A et al (2013) Comparative analysis of oncologic outcomes of partial ureterectomy vs radical nephroureterectomy in upper tract urothelial carcinoma. Urology 81(5):972–977 PubMedCrossRef
43.
Zurück zum Zitat Colin P et al (2012) Comparison of oncological outcomes after segmental ureterectomy or radical nephroureterectomy in urothelial carcinomas of the upper urinary tract: results from a large French multicentre study. BJU Int 110(8):1134–1141 PubMedCrossRef Colin P et al (2012) Comparison of oncological outcomes after segmental ureterectomy or radical nephroureterectomy in urothelial carcinomas of the upper urinary tract: results from a large French multicentre study. BJU Int 110(8):1134–1141 PubMedCrossRef
44.
Zurück zum Zitat Foerster B et al (2019) Endocavitary treatment for upper tract urothelial carcinoma: a meta-analysis of the current literature. Urol Oncol 37(7):430–436 PubMedCrossRef Foerster B et al (2019) Endocavitary treatment for upper tract urothelial carcinoma: a meta-analysis of the current literature. Urol Oncol 37(7):430–436 PubMedCrossRef
45.
Zurück zum Zitat Giannarini G et al (2011) Antegrade perfusion with bacillus Calmette-Guérin in patients with non-muscle-invasive urothelial carcinoma of the upper urinary tract: who may benefit? Eur Urol 60(5):955–960 PubMedCrossRef Giannarini G et al (2011) Antegrade perfusion with bacillus Calmette-Guérin in patients with non-muscle-invasive urothelial carcinoma of the upper urinary tract: who may benefit? Eur Urol 60(5):955–960 PubMedCrossRef
46.
Zurück zum Zitat Kleinmann N et al (2020) Primary chemoablation of low-grade upper tract urothelial carcinoma using UGN-101, a mitomycin-containing reverse thermal gel (OLYMPUS): an open-label, single-arm, phase 3 trial. Lancet Oncol 21(6):776–785 PubMedCrossRef Kleinmann N et al (2020) Primary chemoablation of low-grade upper tract urothelial carcinoma using UGN-101, a mitomycin-containing reverse thermal gel (OLYMPUS): an open-label, single-arm, phase 3 trial. Lancet Oncol 21(6):776–785 PubMedCrossRef
48.
Zurück zum Zitat Peyronnet B et al (2019) Oncological outcomes of laparoscopic nephroureterectomy versus open radical nephroureterectomy for upper tract urothelial carcinoma: an European Association of Urology guidelines systematic review. Eur Urol Focus 5(2):205–223 PubMedCrossRef Peyronnet B et al (2019) Oncological outcomes of laparoscopic nephroureterectomy versus open radical nephroureterectomy for upper tract urothelial carcinoma: an European Association of Urology guidelines systematic review. Eur Urol Focus 5(2):205–223 PubMedCrossRef
49.
Zurück zum Zitat Matin SF et al (2015) Patterns of lymphatic metastases in upper tract urothelial carcinoma and proposed dissection templates. J Urol 194(6):1567–1574 PubMedPubMedCentralCrossRef Matin SF et al (2015) Patterns of lymphatic metastases in upper tract urothelial carcinoma and proposed dissection templates. J Urol 194(6):1567–1574 PubMedPubMedCentralCrossRef
50.
Zurück zum Zitat Kondo T et al (2010) Template-based lymphadenectomy in urothelial carcinoma of the upper urinary tract: impact on patient survival. Int J Urol 17(10):848–854 PubMedCrossRef Kondo T et al (2010) Template-based lymphadenectomy in urothelial carcinoma of the upper urinary tract: impact on patient survival. Int J Urol 17(10):848–854 PubMedCrossRef
51.
Zurück zum Zitat Dominguez-Escrig JL et al (2019) Potential benefit of lymph node dissection during radical nephroureterectomy for upper tract urothelial carcinoma: a systematic review by the European Association of Urology guidelines panel on non-muscle-invasive bladder cancer. Eur Urol Focus 5(2):224–241 PubMedCrossRef Dominguez-Escrig JL et al (2019) Potential benefit of lymph node dissection during radical nephroureterectomy for upper tract urothelial carcinoma: a systematic review by the European Association of Urology guidelines panel on non-muscle-invasive bladder cancer. Eur Urol Focus 5(2):224–241 PubMedCrossRef
53.
Zurück zum Zitat Li WM et al (2010) Oncologic outcomes following three different approaches to the distal ureter and bladder cuff in nephroureterectomy for primary upper urinary tract urothelial carcinoma. Eur Urol 57(6):963–969 PubMedCrossRef Li WM et al (2010) Oncologic outcomes following three different approaches to the distal ureter and bladder cuff in nephroureterectomy for primary upper urinary tract urothelial carcinoma. Eur Urol 57(6):963–969 PubMedCrossRef
54.
Zurück zum Zitat O’Brien T et al (2011) Prevention of bladder tumours after nephroureterectomy for primary upper urinary tract urothelial carcinoma: a prospective, multicentre, randomised clinical trial of a single postoperative intravesical dose of mitomycin C (the ODMIT‑C Trial). Eur Urol 60(4):703–710 PubMedCrossRef O’Brien T et al (2011) Prevention of bladder tumours after nephroureterectomy for primary upper urinary tract urothelial carcinoma: a prospective, multicentre, randomised clinical trial of a single postoperative intravesical dose of mitomycin C (the ODMIT‑C Trial). Eur Urol 60(4):703–710 PubMedCrossRef
55.
Zurück zum Zitat Hosogoe S et al (2018) Platinum-based neoadjuvant chemotherapy improves oncological outcomes in patients with locally advanced upper tract urothelial carcinoma. Eur Urol Focus 4(6):946–953 PubMedCrossRef Hosogoe S et al (2018) Platinum-based neoadjuvant chemotherapy improves oncological outcomes in patients with locally advanced upper tract urothelial carcinoma. Eur Urol Focus 4(6):946–953 PubMedCrossRef
56.
Zurück zum Zitat Kubota Y et al (2017) Oncological outcomes of neoadjuvant chemotherapy in patients with locally advanced upper tract urothelial carcinoma: a multicenter study. Oncotarget 8(60):101500–101508 PubMedPubMedCentralCrossRef Kubota Y et al (2017) Oncological outcomes of neoadjuvant chemotherapy in patients with locally advanced upper tract urothelial carcinoma: a multicenter study. Oncotarget 8(60):101500–101508 PubMedPubMedCentralCrossRef
57.
Zurück zum Zitat Zennami K et al (2021) Two cycles of neoadjuvant chemotherapy improves survival in patients with high-risk upper tract urothelial carcinoma. BJU Int 127(3):332–339 PubMedCrossRef Zennami K et al (2021) Two cycles of neoadjuvant chemotherapy improves survival in patients with high-risk upper tract urothelial carcinoma. BJU Int 127(3):332–339 PubMedCrossRef
58.
Zurück zum Zitat D’Andrea D et al (2021) Comparative effectiveness of neoadjuvant chemotherapy in bladder and upper urinary tract urothelial carcinoma. BJU Int 127(5):528–537 PubMedCrossRef D’Andrea D et al (2021) Comparative effectiveness of neoadjuvant chemotherapy in bladder and upper urinary tract urothelial carcinoma. BJU Int 127(5):528–537 PubMedCrossRef
59.
Zurück zum Zitat Yip W et al (2022) Final results of a multicenter prospective phase II clinical trial of gemcitabine and cisplatin as neoadjuvant chemotherapy in patients with high-grade upper tract urothelial carcinoma. J Clin Oncol 40(6_suppl):440–440 CrossRef Yip W et al (2022) Final results of a multicenter prospective phase II clinical trial of gemcitabine and cisplatin as neoadjuvant chemotherapy in patients with high-grade upper tract urothelial carcinoma. J Clin Oncol 40(6_suppl):440–440 CrossRef
60.
Zurück zum Zitat Kaag MG et al (2010) Changes in renal function following nephroureterectomy may affect the use of perioperative chemotherapy. Eur Urol 58(4):581–587 PubMedPubMedCentralCrossRef Kaag MG et al (2010) Changes in renal function following nephroureterectomy may affect the use of perioperative chemotherapy. Eur Urol 58(4):581–587 PubMedPubMedCentralCrossRef
61.
Zurück zum Zitat Leow JJ et al (2021) Neoadjuvant and adjuvant chemotherapy for upper tract urothelial carcinoma: a 2020 systematic review and meta-analysis, and future perspectives on systemic therapy. Eur Urol 79(5):635–654 PubMedCrossRef Leow JJ et al (2021) Neoadjuvant and adjuvant chemotherapy for upper tract urothelial carcinoma: a 2020 systematic review and meta-analysis, and future perspectives on systemic therapy. Eur Urol 79(5):635–654 PubMedCrossRef
62.
Zurück zum Zitat Hird AE et al (2021) Neoadjuvant versus adjuvant chemotherapy for upper tract urothelial carcinoma: a microsimulation model. Clin Genitourin Cancer 19(2):e135–e147 PubMedCrossRef Hird AE et al (2021) Neoadjuvant versus adjuvant chemotherapy for upper tract urothelial carcinoma: a microsimulation model. Clin Genitourin Cancer 19(2):e135–e147 PubMedCrossRef
63.
64.
Zurück zum Zitat Bellmunt J et al (2021) Adjuvant atezolizumab versus observation in muscle-invasive urothelial carcinoma (IMvigor010): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol 22(4):525–537 PubMedPubMedCentralCrossRef Bellmunt J et al (2021) Adjuvant atezolizumab versus observation in muscle-invasive urothelial carcinoma (IMvigor010): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol 22(4):525–537 PubMedPubMedCentralCrossRef
65.
Zurück zum Zitat Iwata T et al (2019) The role of adjuvant radiotherapy after surgery for upper and lower urinary tract urothelial carcinoma: a systematic review. Urol Oncol 37(10):659–671 PubMedCrossRef Iwata T et al (2019) The role of adjuvant radiotherapy after surgery for upper and lower urinary tract urothelial carcinoma: a systematic review. Urol Oncol 37(10):659–671 PubMedCrossRef
Metadaten
Titel
Urothelkarzinom des oberen Harntraktes: aktuelle Behandlungsstrategien
verfasst von
Maria Marx
Laura-Maria Krabbe
Felix Wezel
Jan-Thorsten Klein
Friedemann Zengerling
Prof. Dr. med. Christian Bolenz
Publikationsdatum
25.07.2022
Verlag
Springer Medizin
Erschienen in
Die Onkologie / Ausgabe 9/2022
Print ISSN: 2731-7226
Elektronische ISSN: 2731-7234
DOI
https://doi.org/10.1007/s00761-022-01220-w