Upper Tract Urothelial Carcinoma (UTUC): Symptoms, Diagnosis & Treatment (2024)

FAQs

What is the meaning of upper tract urothelial carcinoma? ›

Upper tract urothelial cancer (sometimes called transitional cell carcinoma) is a cancer that occurs in either the inner lining of the tube that connects the kidney to the bladder (the ureter) or within the inner lining of the kidney.

The main prognostic factors are tumour stage and grade [111,120,149,150]. Upper urinary tract UCs that invade the muscle have a poor prognosis. In a large Dutch series of UTUC, 5-year CSS was 86% for non- muscle-invasive tumours, 70% for muscle-invasive organ-confined tumours and 44% for locally-advanced tumours [18].

Left untreated, bladder cancer may grow through your bladder walls to nearby lymph nodes and then other areas of your body, including your bones, lungs or liver. Bladder cancer can be high-grade or low-grade: High-grade urothelial carcinoma may be life-threatening. It often comes back after treatment.

Urothelial carcinoma (also called transitional cell carcinoma) is cancer that begins in the urothelial cells, which line the urethra, bladder, ureters, renal pelvis, and some other organs. Almost all bladder cancers are urothelial carcinomas.

The 5-year relative survival rate of people with bladder cancer that has not spread beyond the inner layer of the bladder wall is 96%. Almost half of people are diagnosed with this stage. If the tumor is invasive but has not yet spread outside the bladder, the 5-year relative survival rate is 70%.

Many people with UTUC do not have any symptoms. They are often diagnosed when they have a urine test for another reason and the test detects blood in the urine that can only be seen under a microscope. In some cases, a person with UTUC will see blood in their urine. Less common symptoms include pain in the side.

While the majority of urothelial cancers (approximately 90-95%) arise in the bladder, upper tract urothelial cancers (UTUCs) correspond to a subset of urothelial cancers that arise in the lining of the kidney (called the renal pelvis) or the ureter (the long, thin tube that connects that kidney to the bladder).

These cancers can almost always be cured with treatment. During long-term follow-up care, more superficial cancers are often found in the bladder or in other parts of the urinary system. Although these new cancers do need to be treated, they rarely are deeply invasive or life threatening.

In addition to the other regular signs of bladder cancer, individuals with UTUC may also experience flank pain (discomfort, or pain in the part of the body below the rib). This can occur because the tumor or bleeding may obstruct or block the ureter or kidney. Some people have no signs or symptoms of UTUC.

Is urothelial carcinoma aggressive? ›

Muscle-invasive urothelial carcinomas are highly aggressive compared to cancers of the upper urinary tract, carrying a five-year disease-specific survival rate of <50% in pT2/pT3 disease, and this survival rate drops below 10% in pT4 cancer.

Bladder cancer begins when healthy cells in the bladder lining—most commonly urothelial cells—change and grow out of control, forming a mass called a tumor. Urothelial cells also line the renal pelvis and ureters and urethra.

Blood in the urine is the most common symptom of bladder cancer. Around 80 out of 100 people with bladder cancer (around 80%) have some blood in their urine. Doctors call blood in the urine haematuria (pronounced heem-at-you-ree-ah). You may see the blood in your urine.

Stage 0is is also called carcinoma in situ, which is a flat tumor on the tissue lining the inside of the bladder. Stage 0is is always high grade (see the section on Bladder cancer grade).

For most people, the first symptom of bladder cancer is blood in the urine, also called hematuria. Sometimes the blood is visible, prompting the patient to visit a doctor.

Radical nephroureterectomy is the standard treatment for high-risk UTUC, regardless of tumour location. Open, laparoscopic and robotic approaches have similar oncological outcomes for organ-confined UTUC. Failure to completely remove the bladder cuff increases the risk of BC recurrence.

Upper tract urothelial cancer (sometimes called transitional cell carcinoma or UTUC) is a cancer that occurs in either the inner lining of the tube that connects the kidney to the bladder (the ureter) or within the inner lining of the kidney.

If the cancer is high grade, if many tumors are present, or if the tumor is very large when it's first found, radical cystectomy may be recommended. For people who aren't healthy enough for a cystectomy, radiation therapy (often along with chemo) might be an option, but the chances for cure are not as good.

High-grade bladder cancer cells grow aggressively and may be more likely to spread to the bladder wall and other tissues and organs. Treatment for bladder cancer can include chemotherapy — either directly administered to your bladder or used more broadly, radiation therapy, immunotherapy or surgery.