Vol. 9, No 3, 2002 pp. 213 - 216
UC 616.6:616-006
STATE OF THE ART IN THE DIAGNOSIS AND
TREATMENT
OF THE UPPER UROTHELIAL CANCER
Ivan Ignjatović1, Rade Čukuranović2,
Nebojša Marković1, Vladisav Stefanović2
1Clinic of Urology, Faculty of Medicine,
Niš
2Institute of Nephrology and Hemodialysis,
Faculty of Medicine, Niš, Serbia
Summary. Upper urothelial cancer (UUT) is not a common neoplasm.
It's a biological potential expressed as a more frequent occurrence in
patients with Balkan endemic nephropathy (BEN). Analgesic nephropathy was
discussed in this paper too. The most important facts and dilemmas in the
evaluation, treatment and follow-up of patients with UUT were analyzed.
Diagnosis is still most frequently performed by excretory urography and
retrograde pyelography. Additional diagnostic tools like ureteroscopy,
CT are helpful and even more sensitive but not always approachable. The
therapeutic strategy is based on radical operation. Organ sparing surgery
must be carefully evaluated especially in patients from the regions of
BEN because of different biological behavior of UUT and less expressed
malignancy.
Key words: Urothelial cancer, etiology, diagnosis, therapy
SAVREMENI PRISTUP DIJAGNOZI I LEČENJU
TUMORA
GORNJEG UROTELIJUMA
Kratak sadržaj: Tumori gornjeg urotelijuma nisu česte neoplazme.
Analizirana je njihova češća pojava u regionima Balkanske endemske nefrpatije
(BEN) i kod bolesnika sa Analgezičkom nefropatijom. Najznačajnije činjenice
i dileme u proceni, lečenju i praćenju bolesnika sa tumorima gornjeg urotelijuma
su diskutovane. Dijagnoza se najčešće postavlja intravenskom urografijom
i retrogradnom pijelografijom. Dopunske metode kao uretroskopija i CT su
nekada i osetljivije ali nisu uvek dostupne. Strategija lečenja tumora
gornjeg urotelijuma je bazirana na radikalnoj operaciji. Konzervirajuća
operacija mora se pažljivo razmotriti posebno kod bolesnika iz regiona
BEN zato što tumori imaju drugačije biološko ponašanje i manje izražen
maligni potencijal.
Ključne reči: Tumor urotelijuma, etiologija, dijagnoza, terapija
