About this Research Topic
While upper tract urothelial carcinoma (UTUC) is relatively uncommon, accounting for approximately 5-10% of all urothelial cancers, emerging data suggests underlying differences from urothelial carcinoma of the bladder (UCB) on both a clinical and molecular level. Risk factors unique to UTUC, such as aristolochic acid exposure and Lynch syndrome, amount to regional differences in the incidence of UTUC and may also support disparate biological entities that may translate to differences in therapeutic strategies. Evidence for clinicopathologic or molecular prognostic factors from large UTUC cohorts is accumulating. Accurate clinical staging of UTUC is notoriously limited, and the role for multimodal strategies in treating high-risk, clinically localized disease, including perioperative systemic therapy, continues to evolve. Likewise, novel approaches to preserve renal function and to manage high-volume low-grade disease are emerging. Finally, newer immune checkpoint inhibitors and targeted agents are being explored for treatment based on comprehensive molecular characterization of UTUC tumors.
The Research Topic aims to provide a contemporary update on the current landscape of UTUC management across the full spectrum of disease, with a focus on novel advances in prognostic and predictive models and biomarker discovery. In particular, advances in our understanding of the unique risk factors underlying UTUC will be reviewed, along with their implications for therapy. Biological differences between UTUC and UCB and limitations in clinical staging of UTUC will be discussed. Updates in preclinical efforts, including recently established UTUC patient-derived xenograft (PDX) models, will be shared as a means to encourage more rigorous platforms to study drug trials more precisely. Advances and future outlooks in the treatment of high-volume low-grade UTUC will also be discussed. Finally, it will be tested whether the predictive models based on clinicopathologic, and molecular factors can guide the treatment of UTUC, such as multimodal strategies.
Topics of interest are but not limited to:
• Unique risk factors and epidemiology of UTUC (aristolochic acid, Lynch syndrome, etc.)
• Clinical and molecular differences between UTUC and UCB
• Clinicopathologic and molecular prognostic factors of UTUC
• Predictive modeling in UTUC (limitations in clinical staging; clinical nomograms; emerging comprehensive molecular data in UTUC)
• Preclinical models in UTUC
• Advances in the treatment of low-grade UTUC
• Prospective application of integrated models in disease monitoring and personalized management
Please note: manuscripts consisting solely of bioinformatics or computational analysis of public genomic or transcriptomic databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) are out of scope for this section and will not be accepted as part of this Research Topic.
Keywords: Upper tract urothelial carcinoma, Biomarkers, Nomograms, Prognosis, Therapeutic response
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