Upper tract urothelial carcinoma (UTUC) poses unique challenges in diagnosis and treatment. This comprehensive review focuses on prophylactic intravesical therapy for UTUC, summarizing key aspects of intravesical therapy in various clinical scenarios, including concurrent with or following radical nephroureterectomy, kidney-sparing surgery, ureteroscopy-guided biopsy. The incidence of intravesical recurrence in UTUC after surgical treatment is significant, necessitating effective preventive measures. Intravesical therapy plays a vital role in reducing the risk of bladder recurrence following UTUC surgery. Tailoring timing, drug selection, dosage, and frequency is vital in optimizing treatment outcomes and reducing intravesical recurrence risk in UTUC. This review provides a comprehensive summary of the history, clinical trials, guideline recommendations, and clinical applications of intravesical therapy for UTUC. It also discusses the future directions based on current clinical needs and ongoing trials. Future directions entail optimizing dosage, treatment duration, and drug selection, as well as exploring novel agents and combination therapies. Intravesical therapy holds tremendous potential in improving outcomes for UTUC patients and reducing the risk of bladder recurrence. Although advancements have been made in UTUC treatment research, further refinements are necessary to enhance efficacy and safety.
上尿路尿路上皮癌（UTUC）在诊断与治疗方面面临独特挑战。本文围绕UTUC的预防性膀胱内灌注治疗展开全面综述，系统总结了根治性肾输尿管切除术同期或术后、保留肾脏手术、输尿管镜引导活检等多种临床情境下膀胱内灌注治疗的关键要点。UTUC术后膀胱内复发率较高，亟需有效的预防措施。膀胱内灌注治疗在降低UTUC术后膀胱复发风险方面具有重要作用。优化治疗时机、药物选择、剂量及频次对提升治疗效果、降低膀胱复发风险至关重要。本综述系统梳理了UTUC膀胱内灌注治疗的发展历程、临床试验、指南建议及临床应用现状，并基于当前临床需求与在研试验探讨了未来发展方向。未来研究重点包括优化给药方案、治疗周期与药物选择，探索新型药物及联合治疗策略。膀胱内灌注治疗在改善UTUC患者预后、降低膀胱复发风险方面具有巨大潜力。尽管UTUC治疗研究已取得进展，仍需进一步完善治疗方案以提升疗效与安全性。
Intravesical Therapy for Upper Urinary Tract Urothelial Carcinoma: A Comprehensive Review
肿瘤(癌症)患者之家