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    • Upper Tract Urothelial Carcinoma

 Upper Tract Urothelial Carcinoma (UTUC)

LYNCH SYNDROME

A study of 115 UTUC patients published in Jan 2018 Urology showed 13.9% as potential Lynch syndrome (LS)  and 5.2% confirmed; however, several patients with potential LS failed to follow up to have confirmatory testing. (1) Previous retrospective study results estimated 16%-21% (2,3) The lifetime risk of UTUC in LS patients is 6%, which is 14 to 22 times higher than the general population. (4) The EAU proposed patients w/ suspected UTUC, including those diagnosed before age 60 years, should undergo germline DNA sequencing. (5)

Other Studies

​About 50% of UTUC are upgraded to muscle invasive or high grade on final path. (6)

​This is a nice study that looked at the results of performing retrograde pyelogram for patients who the ureter does not opacify with conrast on CTU.  (8)
  1. Metcalfe, Michael J., et al. "Universal Point of Care Testing for Lynch Syndrome in Patients with Upper Tract Urothelial Carcinoma." The Journal of urology 199.1 (2018): 60-65.
  2. Audenet, François, et al. "A proportion of hereditary upper urinary tract urothelial carcinomas are misclassified as sporadic according to a multi‐institutional database analysis: proposal of patient‐specific risk identification tool." BJU international 110.11b (2012).
  3. Roupret, M., et al. "Microsatellite instability as indicator of MSH2 gene mutation in patients with upper urinary tract transitional cell carcinoma." Journal of medical genetics 41.7 (2004): e91-e91.
  4. Rouprêt, Morgan, et al. "Upper urinary tract urothelial cell carcinomas and other urological malignancies involved in the hereditary nonpolyposis colorectal cancer (lynch syndrome) tumor spectrum." European urology 54.6 (2008): 1226-1236.
  5. Rouprêt, Morgan, et al. "European Association of Urology guidelines on upper urinary tract urothelial cell carcinoma: 2015 update." European urology 68.5 (2015): 868-879.
  6. Margolin, Ezra J., et al. "Discordance between Ureteroscopic Biopsy and Final Pathology for Upper Tract Urothelial Carcinoma." The Journal of urology 199.6 (2018): 1440-1445.
  7. Paspulati, Anirudh, et al. "The utility of retrograde pyelography to follow up incompletely opacified ureters on CT urography." Abdominal Radiology 45.3 (2020): 807-811.
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  • Home
  • Daily Tasks
    • Dictations >
      • Circumcision
      • Cystoscopy >
        • Cysto-OR
        • Cysto, +/- RPG +/- stent >
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        • L U-scope,semirigid laser, flex, RPG, stent removal, (F)
      • ESWL >
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