Aggressive treatment for urothelial cancer-complete urinary tract extirpation: Operative feasibility in two cases

Özet

Bladder cancer (BC), the most common malignancy of the urinary tract, accounts for 90-95% of allurothelial carcinomas (UCs), while upper urinary tract UC (UUTUC) accounts for only 5-10%. Radicalnephroureterectomy with excision of bladder cuff, and radical cystectomy with pelvic lymph node dis-section and a urinary diversion (UD) are the gold standard treatments for UUTUC and muscle-invasivebladder cancer (MIBC), respectively. These two treatments can be performed simultaneously when abilateral or unilateral UUTUC is present with a MIBC, and are called complete urinary tract extirpation(CUTE) and hemi-CUTE, respectively. This complex surgery can help the patient by avoiding multi-staged surgeries, repeated anesthesia, and delay in completion of treatment. Herein, we report the firstcases of a hemi-CUTE and CUTE in our department and share our experience with this aggressive andcomplex surgical treatment.