ABSTRACT

Although upper urinary system urothelial cancer is a rare disease, there are multiple therapeutic choices for patients. Radical nephroureterectomy is still the gold standard intervention. Removal of the ureteric cuff is an important part of both the open and the laparoscopic techniques. Whereas the technological advances in endoscopic procedures provided more patient and nephron friendly strategies to have role in treatment of patients with anatomic or functional solitary kidneys, bilateral upper-tract TCC, baseline renal insufficiency, and significant comorbid diseases. Carefully selected patients with a normal contra-lateral kidney who have small, low-grade lesions are candidates for endoscopic ablation and adjuvant intrarenal immuno-chemotherapies. As the long-term oncologic results matures, less radical surgical options may evolve into mainstream practice.