Upper tract urothelial cancer
What are risk factors for upper tract cancer?
Balkan descent, smoking, ? coffee consumption, analgesic abuse, occupational exposure, Chinese herb (aristocolic acid)
What hereditary syndrome is associated with ureteral tumors, colon tumors, and other tumors?
Lynch syndrome II - autosomal dominant defect in DNA mismatch repair gene hMLH1 and hMSH2. Associated with lots of tumors: colon, ureteral, uterine, pancreatic, ovarian
T/F Ureteral invasion is more common than bladder invasion
Prognosis is typically better for RP tumors
What is a T3 upper tract tumor?
Invasion into sinus/peri-ureteral fat or renal parenchyma
What laser is safer in the ureter?
Holmium:YAG (shallower penetration)
Which laser is better in the RP?
Nd:YAG (works by coagulative necrosis and has deeper penetration)
What should you do after upper tract antegrade ureteroscopy?
Second look in 4-14 days
What is the recurrence rate for retrograde ureteroscopic management of ureteral tumors?
What is the most common complication of upper tract instillation of drugs?
What type of tumor are 90% of upper tract cancers?
Small percentage squamous, adeno, and inverted papilloma
What is Balkan nephropathy?
Interstitial nephritis that causes renal failure in Balkans. Cause unknown. Have 100-200 fold greater risk of UTUC and more likely to develop bilateral disease
What is a good indicator of stage in ureteral cancer?
What is the most important prognostic factor in ureteral cancer?
Where is the majority of upper tract UC?
70% distal ureter
25% mid ureter
5% proximal ureter