Seth P. Lerner, MD, presented “Methods and Guidelines to Stage and Grade (Low vs. High) UTUC and How Should We Treat” at the 6th International Bladder Cancer Update on November 20, 2022, in Scottsdale, Arizona.
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How to cite: Lerner, Seth P. “Methods and Guidelines to Stage and Grade (Low vs. High) UTUC and How Should We Treat.” November 2022. Accessed Dec 2024. https://grandroundsinurology.com/methods-and-guidelines-to-stage-and-grade-low-vs-high-utuc-and-how-should-we-treat/
Methods and Guidelines to Stage and Grade (Low vs. High) UTUC and How Should We Treat – Summary
Dr. Seth P. Lerner discusses the methods and guidelines for staging and grading upper tract urothelial carcinoma (UTUC), providing a detailed and technical overview of current practices and emphasizing the importance of accurate assessment in guiding treatment decisions. Dr. Lerner addresses the anatomical and pathological distinctions between low-grade and high-grade UTUC, highlighting their clinical implications. He explains the TNM (Tumor, Node, Metastasis) staging system, detailing how it is used to categorize the extent of disease and its prognostic significance. He covers the utilization of imaging techniques such as CT urography, MRI, and ureteroscopy, emphasizing their roles in accurately staging UTUC.
Dr. Lerner elaborates on the histopathological criteria used to differentiate low-grade from high-grade tumors, underscoring the prognostic importance of tumor grade in predicting disease progression and guiding treatment strategies. He outlines the standard guidelines for managing low-grade versus high-grade UTUC and discusses nephron-sparing approaches, such as endoscopic ablation and segmental ureterectomy, for low-grade, non-invasive tumors, aiming to preserve renal function while effectively controlling the disease. For high-grade or invasive UTUC, radical nephroureterectomy with bladder cuff excision remains the gold standard. Dr. Lerner provides evidence-based recommendations for perioperative chemotherapy and adjuvant therapy, particularly in high-risk patients, to reduce recurrence and improve survival outcomes.
About the 6th International Bladder Cancer Update:
The International Bladder Cancer Update (IBCU) is a CME conference focused on the diagnosis and treatment of bladder cancer. The conference offers medical professionals an opportunity to listen to updates from, and interact with, expert international faculty to improve knowledge and determine best treatment practices to improve patient outcomes. IBCU encompasses expert lectures, interactive discussions, a panel roundtable, debates, and case presentations. It is physician-led, multi-supported, and designed for urologists, urologic oncologists, and other healthcare professionals involved in the treatment of bladder cancer.
For further educational activities from this conference, visit our collection page.
ABOUT THE AUTHOR
Seth P. Lerner, MD, FACS, is Professor of Urology and Vice-Chair for Faculty Affairs in the Scott Department of Urology at the Baylor College of Medicine in Houston, Texas. He holds the Beth and Dave Swalm Chair in Urologic Oncology. Dr. Lerner is the Director of Urologic Oncology and the Multidisciplinary Bladder Cancer Program, also at Baylor.
Dr. Lerner earned his medical degree from the Baylor College of Medicine, completed a surgical internship at Virginia Mason Hospital in Seattle, and returned to Baylor for his residency training. He completed a two-year fellowship at the University of Southern California in Urologic Oncology and Reconstructive Surgery and joined the full-time Baylor faculty in 1992.
