Kidney Preservation Strategies for Upper Tract Urothelial Cancer

Khurram Mutahir SiddiquiOman Speaker Kidney Preservation Strategies for Upper Tract Urothelial CancerAbstract: Upper tract urothelial carcinoma (UTUC) is a rare but aggressive malignancy that affects the renal pelvis and ureter, often leading to significant challenges in treatment and kidney preservation. This lecture provides a comprehensive overview of the state-of-the-art kidney preservation techniques employed in the management of UTUC, with a focus on preserving renal function while ensuring oncological control. Surgical approaches, including nephron-sparing surgery (NSS) and minimally invasive techniques, such as endoscopic resections and robotic-assisted procedures, are discussed, highlighting their role in achieving optimal outcomes with reduced morbidity. In addition, the importance of careful patient selection based on tumor characteristics, location, and stage is emphasized, as these factors significantly influence the decision-making process regarding kidney preservation versus radical nephroureterectomy. The lecture further explores the evolving role of neoadjuvant and adjuvant therapies, including chemotherapy and immunotherapy, in conjunction with surgical intervention, to improve survival rates while maintaining renal function. Recent advancements in genetic profiling and molecular diagnostics are also addressed, as these innovations may lead to more personalized treatment strategies that preserve the kidney while effectively targeting the malignancy. Lastly, the challenges of balancing oncological safety with renal preservation are discussed, and future directions in research, including potential breakthroughs in regenerative medicine and advanced surgical techniques, are explored. This lecture aims to provide a current and thorough understanding of the multidisciplinary approaches to kidney preservation in UTUC, offering insights into best practices and emerging trends in the field.