Therapeutic Strategies for Asymptomatic Upper Urinary Tract Urothelial Carcinoma

Abstract A total of 136 patients with upper urinary tract epithelial carcinoma (UTUC) were recruited, of which 21 patients with asymptomatic UTUC were group A, and 115 UTUC patients with hematuria or low back pain were group B. The clinicopathological features, oncologic outcomes, and surgical methods of patients were evaluated. The full-length renal ureterectomy+bladder sleeve resection was the main surgical treatment which was included (group A 80.95%, group B 90.43%). Other patients were treated with kidney-retaining surgery. No statistically significant difference was observed in the grading between groups A and B, pathological stage (p >0.05). During a median follow-up period of 44.3 months, tumor-specific mortality of group A was 7.14%, and that of group B was 5.10%. At the same period, the clinical data of 106 patients with asymptomatic bladder tumor were collected: 31 patients of them had asymptomatic bladder urothelial carcinoma. The asymptomatic UTUC group had a higher stage and grade clinicopathological features (P = 0.00), more aggressive than the asymptomatic bladder urothelial carcinoma group. The principle of asymptomatic UTUC treatment is the same as that of symptomatic UTUC. Risk stratification should be carried out according to clinical staging and other parameters, and the corresponding surgical treatment should be selected.