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Erschienen in: Die Urologie 6/2023

31.05.2023 | Urothelkarzinom | CME

Urothelkarzinom des oberen Harntrakts

verfasst von: PD Dr. med. habil. Jennifer Kranz, FEBU, MHBA, Marco Hoffmann, Radu Alexa, Christoph Kuppe, Nadine Therese Gaisa, Matthias Saar

Erschienen in: Die Urologie | Ausgabe 6/2023

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Zusammenfassung

Das Urothelkarzinom des oberen Harntrakts („upper tract urothelial carcinoma“, UTUC) ist bei nahezu identischen Risikofaktoren seltener als das der Harnblase und hat eine schlechtere Prognose. Standard in der Diagnostik ist die Bildgebung des oberen Harntrakts mittels computertomographischer Urographie. Bei diagnostischer Unsicherheit kann neben der Urinzytologie eine diagnostische Ureterorenoskopie mit Probenentnahme durchgeführt werden. Die Therapie hängt in erster Linie vom Stadium und Grading des Tumors ab. Je nach Ausdehnung und Lokalisation ist eine organerhaltende Therapie oder eine radikale Nephroureterektomie indiziert. Eine perioperative Systemtherapie kann beim Hochrisiko-UTUC sowohl im neoadjuvanten als auch adjuvanten Setting erfolgen, wobei die gegenwärtige Datenlage zur neoadjuvanten Chemo- und Immuntherapie noch keine Standardanwendung erlaubt. Für metastasierte Erkrankungen kommt ein multimodaler Therapieansatz aus cis- bzw. carboplatinbasierter Chemotherapie, Immuntherapie und Therapie mit Enfortumab-Vedotin, in seltenen Einzelfällen die Salvage-Operation, die Strahlentherapie oder die Metastasektomie in Betracht.
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Metadaten
Titel
Urothelkarzinom des oberen Harntrakts
verfasst von
PD Dr. med. habil. Jennifer Kranz, FEBU, MHBA
Marco Hoffmann
Radu Alexa
Christoph Kuppe
Nadine Therese Gaisa
Matthias Saar
Publikationsdatum
31.05.2023
Verlag
Springer Medizin
Erschienen in
Die Urologie / Ausgabe 6/2023
Print ISSN: 2731-7064
Elektronische ISSN: 2731-7072
DOI
https://doi.org/10.1007/s00120-023-02079-4

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