The cancer behavior and current treatment strategy for upper urinary tract cancer

Upper urinary tract urothelial carcinomas (UTUCs) are rare diseases, accounting for only 5%–10% of all urothelial cancers. Radical nephroureterectomy (RNU) with bladder cuff excision remains the standard care modality of UTUCs. However, the prognosis is poor and the recurrence is high in patients with advanced UTUC treated with RNU currently. Therefore, identifying cancer behavior for UTUC is an important guide for clinical practice. Herein, we provide an overview of cancer behavior of UTUCs, including prognostic factors and clinical cancer courses. We also discuss the appropriate management of patients with UTUC, such as diagnosis, surgical management, and systemic therapies. Due to the rarity of UTUC, strong evidence of management is often lacking. Therefore, further prospective trials are needed, and regular follow-up after interventions is mandatory.