Urothelkarzinome des oberen Harntrakts

Upper tract urothelial carcinoma (UTUC) is a rare type of cancer. By the time of initial diagnosis, the majority of the tumors have often already progressed to a locally advanced stage. When UTUC is suspected, the primary diagnostic approach is a computed tomography urography for assessing the upper urinary tract. Additional diagnostic methods include retrograde ureteropyelography, selective urine cytology, and/or ureterorenoscopic biopsy. The treatment of UTUC is based on risk stratification into low- and high-risk groups. While kidney-sparing therapy is an option for low-risk groups, radical nephroureterectomy including bladder cuff excision and removal of regional lymph nodes still represents the gold standard for high-risk UTUC. Treatment options for metastatic urothelial carcinoma are currently evolving. Apart from chemotherapy and immunotherapy, the therapy landscape has recently been extended by new agents such as antibody–drug conjugates and fibroblast growth factor receptor (FGFR) inhibitors.