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首页> 外文期刊>The Urologic clinics of North America >Surveillance and management of recurrence for upper tract transitional cell carcinoma.
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Surveillance and management of recurrence for upper tract transitional cell carcinoma.

机译：上路移行细胞癌的复发监测和管理。

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Surveillance of treated upper tract TCC must be tailored to each patient based on individual tumor characteristics. Important risk factors include tumor stage, grade, and multifocality. Molecular markers for TCC may assist in future surveillance strategies, but for now remain experimental. Improvements in imaging eventually may provide the sensitivity needed to determine tumor stage, which would make both initial and recurrence management decisions much more accurate. Initial surgical treatment will influence surveillance when it pertains to superficial disease treated conservatively with either open segmental resection or, now more commonly, with endoscopic resection. Patients treated in this manner require vigilant surveillance of the ipsilateral ureter. Direct visualization in combination with cytology currently appears to be the most effective method, using the same timelines as those used for bladder TCC. Prospective studies concerning surveillance protocols for upper tract TCC would certainly provide more evidence for the current recommendations. However, the evidence does show that upper tract TCC behaves biologically much in the same fashion as does bladder TCC. In light of this fact, the current recommendations are meant to suggest following a patient after treatment for upper tract TCC in a manner similar to that used to follow a patient after treatment of bladder TCC, with individual strategies based on tumor characteristics. For superficial disease, the technology now exists to moniter a patient after endoscopic resection of an upper tract tumor in exactly the same manner used to follow a patient after endoscopic resection of a bladder tumor.
机译：必须根据每个患者的肿瘤特征对每位患者量身定制治疗上道TCC的监测。重要的危险因素包括肿瘤分期，分级和多灶性。 TCC的分子标记可能有助于将来的监测策略，但目前仍处于试验阶段。影像学的改善最终可以提供确定肿瘤分期所需的敏感性，这将使初始和复发管理决策更加准确。当涉及通过开放性节段切除术保守治疗的浅表疾病，或现在更常见的是内窥镜切除术治疗的浅表疾病时，初始手术治疗将影响监视。以这种方式治疗的患者需要对同侧输尿管进行警惕的监视。直接可视化与细胞学结合目前看来是最有效的方法，使用与膀胱TCC相同的时间表。有关上层TCC监测方案的前瞻性研究肯定会为当前建议提供更多证据。但是，证据确实表明，上层TCC的生物学行为与膀胱TCC的行为相同。鉴于这一事实，当前的建议旨在建议对患者进行上道TCC治疗后，采用与治疗膀胱TCC后用于随访患者相似的方式，并根据肿瘤特征采取个别策略。对于浅表疾病，现在存在一种技术，可以以与内窥镜切除膀胱肿瘤后追踪患者的完全相同的方式监测上腹部肿瘤内窥镜切除术后的患者。

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