Comprehensive Review on Upper Tract Urothelial Carcinoma

Upper tract urothelial carcinoma (UTUC) is a relatively uncommon type of cancer; however, its incidence has risen in the past few decades, mainly due to improved detection through advanced imaging and endoscopic technologies. It is an aggressive tumor with up to 60% and 25% of patients presenting with non-organ confined and metastatic diseases at diagnosis, respectively. Radical nephroureterectomy with bladder cuff excision is the gold standard for the management of UTUC, regardless of tumor location. Nevertheless, kidney-sparing techniques, including endoscopic ablation and segmental ureterectomy, have become the preferred options in select patients, especially those with low-risk disease. Despite surgery with curative intent, long-term cancer-specific survival is still low, predominantly due to undetected microscopic metastasis. The management and prognosis of UTUC have improved in recent years, given the widespread use of minimally invasive approaches and novel neoadjuvant and adjuvant systemic therapies.

This Special Issue, titled “Comprehensive Review on Upper Tract Urothelial Carcinoma: An Update in 2023”, highlights different aspects of the multidisciplinary management of UTUC, including imaging, novel diagnostic markers, neoadjuvant and adjuvant therapies, and surgical interventions. It includes 11 papers (1 editorial, 7 review articles, and 3 original papers), all of which were written by experts in the field of UTUC from around the world.