Cayce Nawaf, MD, presented “Endoscopic Management of Upper Tract UC and the Role of Mitomycin” at the 11th Urology Today conference on October 27, 2023.
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How to cite: Nawaf, Cayce. “Endoscopic Management of Upper Tract UC and the Role of Mitomycin.” October 2023. Accessed Sep 2024. https://grandroundsinurology.com/endoscopic-management-of-upper-tract-uc-and-the-role-of-mitomycin/
Endoscopic Management of Upper Tract UC and the Role of Mitomycin – Summary
Cayce Nawaf, MD, discusses the role of mitomycin in the endoscopic management of upper tract urothelial carcinoma (UC). Dr. Nawaf begins with a quick overview of upper tract UC, noting that it is relatively rare.
Dr. Nawaf then compares the outcomes of endoscopic management against those of nephroureterectomy. He illustrates the 5- and 10-year oncologic outcomes from both treatments, demonstrating the similarities between grade groups and presenting the AUA guidelines as additional support.
Dr. Nawaf addresses concerns regarding agent delivery methods to the kidney and presents examples of nephrostomy tubes, double pigtail stents, and ureteral catheters. He presents data from the OLYMPUS Trial supporting the efficacy of retrograde delivery via ureteral catheter.
Regarding agents, Dr. Nawaf presents data on the efficacy of mitomycin. While 58.8-61% of patients had a complete response to the treatment, he notes that there are moderate to severe side effects and caveats around endoscopic management of upper tract UC with mitomycin.
He concludes with a step-by-step guide to using mitomycin in treatment. Dr. Nawaf underscores the importance of selecting patients correctly for treatment based on disease grade and patient preference.
About The 11th Urology Today Conference:
Presented by chair Ryan P. Terlecki, MD, FACS, the 11th Urology Today conference was designed to keep urologists, urologic oncologists, and other healthcare providers educated on the most pertinent issues in urology practices. Areas of focus included urologic oncology, men’s health and reconstruction, female urology, pediatric urology, kidney stones and related conditions, and methods of providing the best care amidst the required logistics of the business side of medicine.
For further educational activities from this conference, visit our collection page.
ABOUT THE AUTHOR
Cayce Nawaf, MD, is a urologist at Atrium Health Wake Forest Baptist Medical Center in Winston-Salem, North Carolina. He earned his medical degree from the University of Tennessee in Memphis, Tennessee, where he also completed an internship. Dr. Nawaf completed his residency in general surgery at Yale New Haven Hospital in New Haven, Connecticut, and was a research fellow at Yale University. Dr. Nawaf completed a urological oncology fellowship at Washington University School of Medicine in St. Louis, Missouri, accredited by the Society of Urologic Oncology. Dr. Nawaf joined the faculty at Wake Forest Baptist in 2023, specializing in urologic oncology with a joint appointment at the Salisbury Veterans Affairs Medical Center.
