Jennifer A. Linehan, MD, presented “UTUC Staging, Diagnosis, Intraureteralpelvis Therapy, Endoscopic Management” at the 7th International Bladder Cancer Update on December 6, 2024, in Dallas, Texas.
How to cite: Linehan, Jennifer A. “UTUC Staging, Diagnosis, Intraureteralpelvis Therapy, Endoscopic Management” December 2024. Accessed Mar 2025. https://grandroundsinurology.com/utuc-staging-diagnosis-intraureteralpelvis-therapy-endoscopic-management/
UTUC Staging, Diagnosis, Intraureteralpelvis Therapy, Endoscopic Management – Summary
Jennifer A. Linehan, MD, examines evolving strategies for managing upper tract urothelial carcinoma (UTUC), highlighting challenges in diagnosis, staging, and treatment selection.
In this 16-minute presentation, Dr. Linehan presents a case study of a 63-year-old patient with recurrent hematuria, which illustrates the complex decision-making in determining tumor invasiveness and selecting between nephroureterectomy (RNU) or kidney-sparing treatments. Imaging remains central to staging, with CT findings and carcinoma in situ being key predictors of invasiveness.
Dr. Linehan shares genomic studies and radiomic analysis as emerging tools that may refine risk stratification. Novel laser technologies, including holmium, thulium, and light touch lasers, show promise in tumor ablation, each with distinct advantages in recurrence rates and tissue penetration. Chemoablation strategies, such as gemcitabine and mitomycin suspensions, are under investigation, with early data suggesting comparable efficacy to traditional approaches. Immunotherapy combinations, including pembrolizumab and BCG, are being explored for high-grade disease, particularly in patients unwilling or unfit for RNU.
Guidelines from major organizations differ significantly in their recommendations for endoscopic management and postoperative instillation therapy, highlighting the need for consensus. The evolving landscape of UTUC treatment emphasizes the balance between oncologic control and renal preservation, with ongoing trials likely to shape future practice.
About the 7th 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
Jennifer A. Linehan, MD, is a board-certified urologist and associate professor of urology and urologic oncology at the Saint John’s Cancer Institute in Santa Monica, California. She completed her medical degree as well as a general surgery internship and urology residency at the University of Arizona, where she also received the George M. Drach Award for the most compassionate urologic resident. She also received awards for research in diagnosis and management of kidney cancer. Most recently, she received the Harold H. Benjamin Innovation Award for compassion and dedication in cancer care. After her residency at the University of Arizona, Dr. Linehan completed a two-year fellowship in robotic urologic oncology at City of Hope.
Dr. Linehan’s current research focus is on molecular testing using miRNA and cfDNA in urine for tumor identification in renal tumors, 3D imaging to improve surgical outcomes, and new intracavitary therapy for urothelial carcinoma. She continues to practice general urology including complex robotic reconstruction, voiding dysfunction, and treatment of nephrolithiasis. In addition, Dr. Linehan has been involved in prostate cancer research and biomarker identification for this disease. She has authored papers, presented abstracts and research at conferences around the world, and continues to dedicate time to both science and clinical research. Dr. Linehan is certified by the American Board of Urology and is a member of the Society of Urologic Oncology, Endourological Society, American Urological Association, and the Western Section of the American Urological Association. She also has a lifelong love of animals, particularly rescue dogs. She dedicates time weekly to help educate less fortunate families and children.
