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Review
. 2024 May 17:16:467-475.
doi: 10.2147/CMAR.S445529. eCollection 2024.

Upper Tract Urothelial Carcinoma (UTUC): Prevalence, Impact and Management Challenge

Elizabeth Nally  1 , Matthew Young  1 , Vishwani Chauhan  2 , Connor Wells  1 , Bernadett Szabados  1 , Thomas Powles  1 , Francesca Jackson-Spence  1
Affiliations
Review

Upper Tract Urothelial Carcinoma (UTUC): Prevalence, Impact and Management Challenge

Elizabeth Nally et al. Cancer Manag Res. .

Abstract

Upper tract urothelial carcinoma (UTUC) is an aggressive and difficult malignancy to treat. Owing to its rarity and the lack of specific high-level data, management mirrors that of urothelial cancer of the bladder (UCB). Over the past decade, UTUC has shown minimal improvement in survival rates. Its location makes the diagnosis and staging of UTUC more complex. Moreover, surgery often leads to a decline in renal function, rendering a proportion of patients ineligible for cisplatin. There is debate as to how best manage locally advanced UTUC perioperatively. Although immune checkpoint inhibitors (ICIs) have changed the treatment landscape for UCB, the response to ICIs in UTUC has been variable. With new technologies, our understanding of the molecular biology of UTUC has grown, helping to identify key molecular differences from UCB. This review summarises the evidence available on UTUC as a disease entity, discusses treatment in perioperative and metastatic settings, and considers future directions for the management of patients diagnosed with UTUC.

Keywords: immunotherapy; targeted therapy; upper tract; urothelial.

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Conflict of interest statement

Dr Francesca Jackson-Spence reports travel expenses from EUSA and Roche, outside the submitted work. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Forest plot of hazard ratios in upper and lower tract urothelial carcinoma subgroups across first-, second- and third-line RCTs.
See this image and copyright information in PMC

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