First Successful Experience of Organ-Preserving Endoscopic Surgical Treatment for Upper Urinary Tract Urothelial Carcinoma

Transition cell cancer of the upper urinary tract accounts for about 5% of all urothelial tumors. Monofocal localization of the tumor is more common. The simultaneous bilateral position of the lesion is extremely rare, and according to a large Swedish study led by Holmang et al. covers less than 1.6% of all cases. Radical nephroureterectomy with bladder resection is the gold standard for the treatment of transition cell cancer of upper urinary tract. The analysis of 1,462 patients (992 males and 470 females) treatment results shows no positive progress in clinical outcomes during last three decades, despite the advances in both medical science and technology. Hall with co-authors have conducted multi-factor analysis of the treatment results for 30-year period and noted that Upper Urinary Tract Urothelial Carcinoma (UTUC) relapse frequency depends on the tumor stage and the type of surgical treatment. Moreover, the tumor relapse rate is significantly high in case of organ-preserving surgical approach. Implementation of robotic nephroureterectomy has not also allowed improving sufficiently the treatment results. Nephroureterectomy in case of urothelial cancer of the only or single-functional kidney inevitably leads to program lifetime hemodialysis, which itself increases mortality rate from the non-oncological causes