Upper Tract Urothelial Carcinoma
UTUC is urothelial cancer (the same cell type as bladder cancer) but in the renal pelvis or ureter — far rarer, but with a crucial twist: the kidney is at stake.
The big picture
UTUC is urothelial cancer (the same cell type as bladder cancer) but in the renal pelvis or ureter — far rarer, but with a crucial twist: the kidney is at stake. So the central decision is radical nephroureterectomy (remove the whole kidney and ureter) versus kidney-sparing treatment, and that hinges on risk stratification — grade, stage, size, and multifocality. Because it shares biology with bladder cancer, these patients also need bladder surveillance.
The framework: suspect it (haematuria, filling defect) → diagnose and grade (ureteroscopy + biopsy) → risk-stratify → radical nephroureterectomy vs kidney-sparing → surveil the bladder.
Mechanism pathway
Tap any step to see why it happens.
Interactive — UTUC risk stratification & management
Diagnostic algorithm
Each step answers one question. Tap to expand.
Board traps
UTUC = urothelial cancer of the renal pelvis/ureter; haematuria is the commonest sign.
Ureteroscopy + biopsy grades the tumour and drives the radical-vs-kidney-sparing decision.
High-risk → radical nephroureterectomy WITH a bladder cuff (+ single post-op intravesical chemo).
Low-risk → kidney-sparing (ureteroscopic ablation / segmental ureterectomy); also for imperative cases (solitary kidney).
Surveil the bladder — shared field-change biology means frequent bladder recurrence.
Lynch syndrome is associated with UTUC — consider in young patients.