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AUA: Upper Tract Urothelial Carcinoma (2023): Difference between revisions

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** '''Provides supplemental histologic data to tumor biopsies'''
** '''Provides supplemental histologic data to tumor biopsies'''
***'''High-grade cytology in the setting of low-grade biopsy findings indicates the likely presence of higher-risk features (e.g., high-grade tumor) missed on biopsy sampling.'''
***'''High-grade cytology in the setting of low-grade biopsy findings indicates the likely presence of higher-risk features (e.g., high-grade tumor) missed on biopsy sampling.'''
**Urine cytology is reported according to 7 categories (Paris System):  
**'''Specimen collection considerations'''
***'''Can be obtained either as barbotage (saline irrigation and aspiration) or by saline irrigation with passive collection (washings)'''
****'''Preferred over a voided urinary specimen''', due to (3)
****#Improve cellular yield
****#Avoid potential contamination in case of concomitant bladder and/or prostatic urethral disease
****#Avoid theoretical dilution of the specimen from a normal contralateral unit
***'''Should be collected prior to any contrast use to avoid artifactual cellular changes from contrast solutions'''
***'''Collecting selective cytology after tumor biopsy can improve the yield of cells for cytologic analysis.'''
**Urine cytology is reported according to 7 categories (Paris System):
**#Non-diagnostic
**#Non-diagnostic
**#Negative for high-grade urothelial carcinoma
**#Negative for high-grade urothelial carcinoma
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**#Low-grade urothelial neoplasm
**#Low-grade urothelial neoplasm
**#Other malignancies
**#Other malignancies
**'''Can be obtained either as barbotage (saline irrigation and aspiration) or by saline irrigation with passive collection (washings)'''
**'''Preferred over a voided urinary specimen''', due to (3)
**#Improve cellular yield
**#Avoid potential contamination in case of concomitant bladder and/or prostatic urethral disease
**#Avoid theoretical dilution of the specimen from a normal contralateral unit
**'''Should be collected prior to any contrast use to avoid artifactual cellular changes from contrast solutions'''
**'''Collecting selective cytology after tumor biopsy can improve the yield of cells for cytologic analysis.'''
*'''<span style="color:#ff0000">Assessment of renal function</span>'''
*'''<span style="color:#ff0000">Assessment of renal function</span>'''
**Initial decisions regarding operative approach and administration of systemic therapy are based on patients’ baseline renal function and their estimated post-operative estimated glomerular filtration rate (eGFR).  
**Initial decisions regarding operative approach and administration of systemic therapy are based on patients’ baseline renal function and their estimated post-operative estimated glomerular filtration rate (eGFR).  
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