Current Evidence on Utility, Outcomes, and Limitations of Endoscopic Laser Ablation for Localized Upper Urinary Tract Urothelial Carcinoma: Results from a Scoping Review

• Published in: European urology open science (Online) Vol. 59; pp. 7 - 17
• Main Authors: Giulioni, Carlo, Pirola, Giacomo Maria, Maggi, Martina, Brocca, Carlo, Tramanzoli, Pietro, Stramucci, Silvia, Mantovan, Matteo, Perpepaj, Leonard, Cicconofri, Andrea, Gauhar, Vineet, Galosi, Andrea Benedetto, Castellani, Daniele
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier 01-01-2024
• Subjects: Endoscopic treatment; Laser; Nephron-sparing surgery; Review – Urothelial Cancer; Survival; Upper urinary tract urothelial carcinoma; Upper urinary tract urothelial carcinoma; Nephron-sparing surgery; Endoscopic treatment; Survival; Laser
• ISSN: 2666-1683; 2666-1691; 2666-1683
• DOI: 10.1016/j.euros.2023.11.005

The occurrence of upper urinary tract urothelial carcinoma (UTUC) is uncommon and is usually identified at an advanced and multifocal stage. Currently, there is growing interest in utilizing endoscopic laser ablation (ELA).
To evaluate the survival rates and perioperative complications of ELA.
We performed a literature search through PubMed, Web of Science, and Scopus. The analysis included observational studies that examined the oncological outcomes of patients with UTUC treated with ELA.
Neodymium and diode lasers are no longer used due to their high complication rates. Holmium:yttrium-aluminum-garnet (YAG) and thulium:YAG lasers provided excellent tumor ablation and hemostasis in both the collecting system and the ureter. These lasers offer good disease-free and cancer-specific survival, especially for low-grade tumors.
Advancements in laser technology and ablation techniques, and understanding of UTUC tumor biology hold significant promise in improving the use of conservative UTUC treatment, with excellent safety and good oncological outcomes for low-grade diseases.
With the advancement of technology, the conservative approach utilizing endoscopic laser ablation for upper tract urothelial tumors has been proved to be both safe and effective, showcasing promising survival rates.