保留肾入路治疗上尿路上皮癌：最新证据

IF 2.4 3区医学 Q2 UROLOGY & NEPHROLOGY

Asian Journal of Urology Pub Date : 2025-07-01 DOI:10.1016/j.ajur.2024.08.003

Ivan Ching Ho Ko , Chris Ho Ming Wong , David Ka Wai Leung , Alex Qin-yang Liu , Kevin Cheuk Kin Cheng , Brian Wai Hei Siu , Steffi Kar Kei Yuen , Nikhil Vasdev , Keiichiro Mori , Karl H. Tully , Dmitry Enikeev , Anthony Chi Fai Ng , Jeremy Yuen Chun Teoh

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引用次数: 0

摘要

目的综述上尿路上皮癌（UTUC）患者肾保留手术（KSS）的最新进展和预后。方法使用PubMed和Embase数据库进行综合文献检索，确定近10年发表的相关英语研究。关键词包括“上尿路肿瘤/癌/癌”、“保肾手术或入路”、“上尿路肿瘤/癌/癌的内镜治疗”、“上尿路局部滴注”及“尿路上皮癌的尿标记物”。对已确定文献中的参考文献进行了探索和相关性评估。结果skss推荐用于低风险和部分高风险的UTUC，有必要的适应症，如孤立肾。研究表明，与经过精心挑选的病例进行根治性肾输尿管切除术相比，经内镜消融、输尿管节段切除和局部灌注新型药物的KSS后的肿瘤预后相当。新型诊断工具和风险分层模型的发展允许在不影响肿瘤结果的情况下为KSS选择最佳病例。结论在技术进步、更好的诊断工具和新的治疗药物的推动下，保留肾脏入路治疗UTUC是泌尿外科肿瘤中一个不断发展和有前景的领域。我们的文章提供了最新进展和临床建议的全面回顾。虽然目前的证据主要基于回顾性研究，但需要前瞻性试验来解决该领域重要但未解决的临床问题。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Kidney-sparing approach for upper tract urothelial carcinoma: An update on current evidence

Objective

This article reviews the latest updates and outcomes of kidney-sparing surgery (KSS) in patients with upper tract urothelial carcinoma (UTUC).

Methods

A comprehensive literature search was performed using the PubMed and Embase databases to identify related English-language studies published within the last 10 years. Key search words included “upper urinary tract tumour/cancer/carcinoma”, “kidney-sparing surgery or approach”, “endoscopic treatment for upper tract tumour/cancer/carcinoma”, “topical instillation in the upper urinary tract”, and “urinary marker for urothelial carcinoma”. References within the identified literature were explored and evaluated for relevance.

Results

KSS is recommended for both low-risk and selected high-risk UTUC with imperative indications such as solitary kidney. Studies have shown comparable oncological outcomes after KSS including endoscopic ablation, segmental ureterectomy, and topical instillation of novel agents when compared to radical nephroureterectomy in well-selected cases. The development of novel diagnostic tools and risk-stratifying models allows optimal case selection for KSS without compromising oncological outcomes.

Conclusion

Kidney-sparing approach for UTUC is an evolving and promising area in urologic oncology, driven by advances in technology, better diagnostic tools, and novel therapeutic agents. Our article provides a comprehensive review of the latest advancements and clinical recommendations. While current evidence is mainly based on retrospective studies, prospective trials are required to address important but unanswered clinical questions in this field.

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来源期刊

Asian Journal of Urology UROLOGY & NEPHROLOGY-

CiteScore

4.00

自引率

3.80%

发文量

100

审稿时长

4 weeks

期刊介绍： Asian Journal of Urology (AJUR), launched in October 2014, is an international peer-reviewed Open Access journal jointly founded by Shanghai Association for Science and Technology (SAST) and Second Military Medical University (SMMU). AJUR aims to build a communication platform for international researchers to effectively share scholarly achievements. It focuses on all specialties of urology both scientifically and clinically, with article types widely covering editorials, opinions, perspectives, reviews and mini-reviews, original articles, cases reports, rapid communications, and letters, etc. Fields of particular interest to the journal including, but not limited to: • Surgical oncology • Endourology • Calculi • Female urology • Erectile dysfunction • Infertility • Pediatric urology • Renal transplantation • Reconstructive surgery • Radiology • Pathology • Neurourology.