Upper Urinary Tract Urothelial Carcinoma
This comprehensive text examines the diagnostic and treatment strategies of bladder urothelial carcinoma. The authors present a balanced scientific and practical approach to various treatments, such as diagnostic modalities, endoscopic treatments, s
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Upper Urinary Tract Urothelial Carcinoma
Michael Grasso III • Demetrius H. Bagley Editors
Upper Urinary Tract Urothelial Carcinoma
Editors Michael Grasso III Lenox Hill Hospital Department of Urology New York Medical College Valhala, NY USA
Demetrius H. Bagley Department of Urology Thomas Jefferson University Philadelphia, PA USA
ISBN 978-3-319-13868-8 ISBN 978-3-319-13869-5 DOI 10.1007/978-3-319-13869-5
(eBook)
Library of Congress Control Number: 2015944701 Springer Cham Heidelberg New York Dordrecht London © Springer International Publishing Switzerland 2015 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper Springer International Publishing AG Switzerland is part of Springer Science+Business Media (www.springer.com)
Preface
Recently, there have been changes in the diagnosis, treatment, and overall management of upper tract urothelial carcinoma. Although there have been suggestions that there is an increased frequency of these lesions, it is difficult to be certain because renal carcinoma and renal pelvic tumors are grouped together by coding. General success of various treatments in the lower urinary tract with preservation of the bladder leave the upper urinary tract naïve to intravesical therapies. Thus, it may remain as a reservoir of untreated urothelial tissue. The many studies of nephrectomy for renal cell carcinoma have demonstrated the value of preserving nephrons. This has been extended to increase the urgency of preservation with urothelial carcinoma as well. The presentation of upper urinary tract urothelial carcinoma (UTUC) may be very nonspecific with hematuria as the most common finding. Radiographic studies may be indicative but are rarely definitive. Cytology and urinary markers similarly are often not diagnostic or specific. Endoscopic diagnosis is thus essential, most commonly requiring meticulous inspection of the upper tract urothelium with a steerable, flexible ureteropyeloscope and biopsy of any lesion detect
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