Upper Tract Urothelial Cancer

Upper tract urothelial carcinomas (UTUC) are distinct from urinary bladder cancer in terms of phenotypical and genotypical (genetic and epigenetic) differences. Many risk factors are found to be associated with the development of UTUC, and the most common one is tobacco consumption. Microscopic or gross hematuria is the most common presentation. Tumor grade as well as stage of the disease is a critical determinant when choosing the treatment options for UTUC. Radical nephroureterectomy with the removal of the ipsilateral bladder cuff is the gold-standard treatment. With refined diagnostic techniques and treatment modalities, the management of patients with UTUC has changed significantly in recent decades. Minimally invasive techniques for the diagnosis and management of UTUC led to a paradigm shift in treatment strategy. The role of perioperative chemotherapy is better understood now. There are multiple ongoing studies to further improve the methods for screening, treatment and surveillance of UTUC.