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Intracavitary Topical Chemo and Immune Therapy of the Upper Tract

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Urothelial Malignancies of the Upper Urinary Tract

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Abstract

Endourologic management of upper tract urothelial carcinoma has become the preferred treatment in selected groups of patients. However, recurrence is high and there is a large interest in utilizing adjuvant topical agents as used in the lower tract. Many agents have been studied, but they are less efficacious than they are in the lower tract. This is likely due to incomplete staging, difficult delivery, and incomplete resection. There is evidence that primary BCG for isolated carcinoma in situ has some efficacy, but the evidence is not robust. There is mixed evidence for the use of adjuvant BCG, Mitomycin C, and Adriamycin. In our institution (ME), we utilize adjuvant Mitomycin C for a 6-week course in the office following resection. The future of adjuvant therapy likely lies in products such as MitoGel© that coat the upper tract.

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Abbreviations

Radical Nephroureterectomy:

RNU

Upper Tract Urothelial Carcinoma:

UTUC

Mitomycin C:

MMC

Bacillus Calmette–Guérin:

BCG

Percutaneous nephrostomy:

PCN

Carcinoma in situ:

CIS

Trans Urethral Resection Bladder Tumor:

TURBT

Renal Units:

RU

Interferon:

IFN

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Author information

Authors and Affiliations

  1. Department of Urology, Westchester Medical Health Network/New York Medical College, Valhalla, NY, 10595, USA

    Joel Hillelsohn & Majid Eshghi

  2. Department of Urology, Northwell Health and Hofstra University, New Hyde Park, Lake Success, NY, 11040, USA

    Arthur D. Smith

Authors
  1. Joel Hillelsohn
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  2. Majid Eshghi
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  3. Arthur D. Smith
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Corresponding author

Correspondence to Joel Hillelsohn .

Editor information

Editors and Affiliations

  1. Chief, Section of Endourology and Minimally Invasive Urology, Westchester Medical Health Network, Valhalla, New York, USA

    Majid Eshghi

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Hillelsohn, J., Eshghi, M., Smith, A.D. (2018). Intracavitary Topical Chemo and Immune Therapy of the Upper Tract. In: Eshghi, M. (eds) Urothelial Malignancies of the Upper Urinary Tract. Springer, Cham. https://doi.org/10.1007/978-3-319-51263-1_28

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  • DOI: https://doi.org/10.1007/978-3-319-51263-1_28

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-51261-7

  • Online ISBN: 978-3-319-51263-1

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