Endoscopic treatment for upper urinary tract urothelial carcinoma: Indication and outcome

Nephroureterectomy has been considered the "gold standard" of treatment for upper urinary tract urothelial carcinoma (UUT-UC). However, endoscopic treatment such as ureteroscopy, and percutaneous renal surgery has been generally accepted for patients requiring a nephron-sparing approach (i. e., solitary kidney or renal insufficiency) and for those with significant comorbidities precluding definitive surgery. With the development of flexible and durable ureteroscopes that have a smaller diameter, the rate of histological diagnosis has improved significantly. We herein review current reports and our own experience regarding the endoscopic management of UUT-UC. Endoscopic management is a safe and effective treatment alternative to nephroureterectomy in the management of UUT-UC. Survival outcomes are comparable, but renal preservation therapy offers the advantage of reduced morbidity, fewer complications, and the potential for a better quality of life. However, recurrence and disease progression are not uncommon and underscore the need for strict tumor surveillance.