Pathogenesis and treatment of upper urinary tract cancer.

Upper urinary tract cancer originates in the renal pelvis or ureter and is relatively uncom- mon. The predilection age is 65 to 79 years in Japan. Currently, a diagnosis is usually con- firmed using computed tomography urography. Although radical nephroureterectomy with bladder cuff excision is the gold standard treatment for localized disease, nephron-sparing surgery using a transureteroscopic approach has also been performed for unifocal, small, and low-grade tumors. For advanced disease, platinum-based combination chemotherapy is administered, but there is little known about its effect, unlike for bladder cancer, which is a lower urinary tract cancer. Although older age is reported as one of the prognostic factors in upper urinary tract cancer, age alone should not prevent curative treatment.