Urol. praxi. 2025;26(4):204-208 | DOI: 10.36290/uro.2025.088

Upper tract urothelial carcinomas

MUDr. Michaela Šafářová, FEBU, MUDr. Šárka Kudláčková, Ph.D.

Urologická klinika Fakultní Nemocnice Olomouc

Urothelial carcinoma is the second most frequently diagnosed malignity in urology. However, upper tract urothelial carcinomas (UTUC) account only for 5-10% of diagnosed urothelial carcinomas. The diasease is twice more frequent in men than women. Main risk factors include smoking and consumption of aristolochic acid. The most frequent symptom is macroscopic haematurie, which may be absent in up to 20 % of patients. According to the EAU Guidelines (2025) it is neccessary to stage the pacient according to the TNM classification and assess if it is either low or high risk localised disease or metastatic disease. The therapy of each stage is very different - for low risk localised disease kidney sparing surgery is indicated. On the other hand, high risk localised disease requires radical nephroureterectomy. Metastatic disease (cN+) is treated with systemic therapy. The main challange with UTUC is the late diagnosis resulting in more advanced stage of the disease and therefore a worse prognosis of the patient.

Keywords: upper urinary tract, UTUC, urothelial carcinoma, localised disease, systemic therapy.

Accepted: November 24, 2025; Published: December 16, 2025  Show citation