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Upper Urinary Tract Urothelial Cancer
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=== AUA === * [https://pubmed.ncbi.nlm.nih.gov/37096584/ '''2023 AUA Guidelines on Upper Tract Urothelial Carcinoma'''] ** '''<span style="color:#ff0000">Categorized as high- vs. low-risk</span>''' of disease progression and pathologic stage β₯T2 disease ***'''<span style="color:#ff0000">Based on biopsy grade</span>''' ****Association of high grade tumor on ureteroscopic biopsy with high-stage disease (β₯pT2) on final pathology *****Positive predictive value: 60% *****Negative predictive value:77% ***'''<span style="color:#ff0000">Sub-stratified into favorable vs. unfavorable (see [https://www.auajournals.org/doi/10.1097/JU.0000000000003480 Table 4]), based on (4):</span>''' ***#'''<span style="color:#ff0000">Cytology</span>''' ***#'''<span style="color:#ff0000">Radiographic appearance</span>''' ***#*'''<span style="color:#ff0000">Multifocality</span>''' ***#*'''<span style="color:#ff0000">Size</span>''' ***#*'''<span style="color:#ff0000">Invasive features</span>''' ***#**Heterogenous texture on enhanced and even unenhanced CT imaging has been associated with invasive disease ***#*'''<span style="color:#ff0000">Obstruction of the urinary tract</span>''' ***#*'''<span style="color:#ff0000">Locoregional progression such as suspicious lymphadenopathy</span>''' ***#*'''<span style="color:#ff0000">Presence of metastatic disease</span>''' ***#'''<span style="color:#ff0000">Endoscopic appearance</span>''' ***#*'''<span style="color:#ff0000">Appearance (sessile, papillary, flat/villous)</span>''' ***#*'''<span style="color:#ff0000">Multifocality</span>''' ***#*'''<span style="color:#ff0000">Size</span>''' ***#**Tumors β₯ 1.5 cm in size are associated with a > 80% risk of invasive disease ***#**Measurement in the pre-surgical setting is not standardized and has not been shown to be independent of other more easily determined clinically identified features such as multifocality, invasion and obstruction. ***#'''<span style="color:#ff0000">Lower tract involvement</span>''' ***#*'''Pan-urothelial disease as indicated by history of prior cystectomy, concomitant or metachronous lower tract urothelial cancer or contralateral UTUC diagnosis'''
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