Recurrence of urothelial bladder cancer in the upper urinary tract after radical cystectomy: is there prevention and what are the treatment options?

Perlin D.V., Shmanev A.O., Shamkhalov Sh.N., Zipunnikov V.P.

1) Volgograd Regional Center of Urology and Nephrology, Volzhsky, Volgograd Region, Russia; 2) Volgograd State Medical University, Ministry of Health of the Russian Federation, Volgograd, Russia

Abstract. Radical cystectomy is recognized as the gold standard in the management of muscle-invasive bladder cancer. However, despite its definitive nature, recurrences of urothelial carcinoma in the upper urinary tract remain an important cause of morbidity and mortality during long-term follow-up. The prognosis of such recurrences is generally poor, largely due to delayed diagnosis.
This article presents three clinical cases of upper urinary tract recurrence detected 16–24 months after radical cystectomy. Successful treatment was achieved with radical nephroureterectomy including excision of the adjacent intestinal segment. These cases highlight the effectiveness of this surgical approach for upper tract recurrences following radical cystectomy and emphasize the need to establish criteria to determine whether urothelial tumors in the upper urinary tract represent true recurrences of bladder cancer or previously undiagnosed primary lesions. Further studies are required to develop algorithms for the early detection and management of this relatively rare pattern of disease progression.

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About the Authors

Corresponding author: A.O. Shmanev – urologist, Volgograd Regional Center of Urology and Nephrology, Volzhsky, Volgograd Region, Russia; e-mail: sparta238@yandex.ru

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