Upper tract urothelial carcinoma: can the tumor be removed en bloc?
https://doi.org/10.17650/1726-9776-2022-18-3-123-127
Abstract
Diagnosis and treatment of upper tract urothelial carcinoma (UTUC) remain important problems of clinical urology. UTUC en bloc i.e. in one-piece removal during organ-sparing surgery is still hardly possible. The most typical endourological operations are either electrosurgery, holmium or thulium YAG laser tumor vaporization.
We present a clinical case of ureteroscopic en bloc UTUC removal using a new super pulse thulium fiber laser (SPTFL, FiberLase U3). Recent innovations and trends in this field are also discussed. The technical steps of en bloc ureteroscopic tumor removal allowing for diagnosis verification, identification of pT stage and surgical margin are described. The further innovations in laser UTUC removal include modulation of laser pulse length and development of the correlation between preoperative tumor characteristics and possibility of en bloc removal.
Supporting agencies: The work was performed without external funding.
About the Authors
A. G. Martov
State Scientific Center of the Russian Federation – A.I. Burnazyan Federal Medical Biophysical Center, Federal Medical and Biological Agency; D.D. Pletnev City Clinical Hospital, Moscow Healthcare Department; Medical Scientific Education Center, M.V. Lomonosov Moscow State University
Russian Federation
Competing Interests:
Russian Federation
Aleksey Georgievich Martov
Urology and Andrology Department, Medical and Biological University of Innovation and Continuous Education
Build. 8, 46 Zhivopisnaya St., Moscow 123098;
Build. 1, 32 11th Parkovaya St., Moscow 105077;
Build. 10, 27 Lomonosovskiy Prospekt, Moscow 119991
Competing Interests:
The authors declare no conflict of interest.
D. V. Ergakov
State Scientific Center of the Russian Federation – A.I. Burnazyan Federal Medical Biophysical Center, Federal Medical and Biological Agency; D.D. Pletnev City Clinical Hospital, Moscow Healthcare Department
Russian Federation
Competing Interests:
Russian Federation
Urology and Andrology Department, Medical and Biological University of Innovation and Continuous Education
Build. 8, 46 Zhivopisnaya St., Moscow 123098;
Build. 1, 32 11th Parkovaya St., Moscow 105077
Competing Interests:
The authors declare no conflict of interest.
A. S. Andronov
State Scientific Center of the Russian Federation – A.I. Burnazyan Federal Medical Biophysical Center, Federal Medical and Biological Agency; D.D. Pletnev City Clinical Hospital, Moscow Healthcare Department
Russian Federation
Competing Interests:
Russian Federation
Urology and Andrology Department, Medical and Biological University of Innovation and Continuous Education
Build. 8, 46 Zhivopisnaya St., Moscow 123098;
Build. 1, 32 11th Parkovaya St., Moscow 105077
Competing Interests:
The authors declare no conflict of interest.
References
1. Roupret M., Babjuk M., Comperat E. et al. European Association of Urology Guidelines on upper urinary tract urothelial carcinoma: 2017 update. Eur Urol 2018;73(1):111–22. DOI: 10.1016/j.eururo.2017.07.036
2. Herrmann T.R.W., Liatsikos E.N., Nagele U. et al. EAU Guidelines on laser technologies. Eur Urol 2012;61(4):783–95. DOI: 10.1016/j.eururo.2012.01.010
3. Sorokin N.I., Enikeev D.V., Dymov A.M. et al. Safety and efficacy of thulium transurethral en block resection with fiber laser “Urоlaz” for treatment of nonmuscleinvasive bladder cancer. Onkourologiya = Cancer Urology 2018;14(1):144–51. (In Russ.). DOI: 10.17650/172697762018141144151
4. Martov A.G., Ergakov D.V., Anronov A.S. et al. Thulium fiber laser in endoscopic treatment of upper tract transitional cell carcinoma. Urologiya = Urology 2020;5(suppl.):214. (In Russ.).
5. Defidio P.A., De Dominicis M., Di Gianfrancesco L., Fuchs G. First collaborative experience with thulium laser ablation of localized upper urinary tract urothelial tumors using retrograde intrarenal surgery. Arch Ital Urol Androl 2011;83(3):147–53.
6. Kata S.G., Aboumarzouk O.M., Zreik A. et al. Photodynamic diagnostic ureterorenoscopy: a valuable tool in the detection of upper urinary tract tumour. Photodiagn Photodyn Ther 2016;13:255–60. DOI: 10.1016/j.pdpdt.2015.08.002
7. Musi G., Mistretta F.A., Marenghi C. et al. Thulium laser treatment of upper urinary tract carcinoma: a multiinstitutional analysis of surgical and oncological outcomes. J Endourol 2018;32(3):257–63. DOI: 10.1089/end.2017.0915
8. Linehan J., Schoenberg M., Seltzer E. et al. Complications associated with ureteroscopic management of upper tract urothelial carcinoma. Urology 2021;147:87–95. DOI: 10.1016/j.urology.2020.09.036
Review
For citations:
Martov A.G., Ergakov D.V., Andronov A.S. Upper tract urothelial carcinoma: can the tumor be removed en bloc? Cancer Urology. 2022;18(3):123-127. (In Russ.) https://doi.org/10.17650/1726-9776-2022-18-3-123-127
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