Endoluminal instillation of epidoxorubicin as adjuvant treatment for upper urinary tract urothelial tumours.

Intravesical use of chemotherapeutic agents has been documented as effective and beneficial in the treatment and prophylaxis of bladder urothelial cancer. Because of the success achieved with these agents, several investigators have proposed these same drugs as adjuvant treatment after conservative procedures for urothelial tumours of the upper urinary tract. Experiences concerning topical therapy for upper tract urothelial neoplasms are still limited, but suggest a great potential benefit in terms of improved tumour control. Advances in endourologic techniques and increasing interest in the conservative management of upper urinary tract urothelial cancer may lead to more frequent use of topical chemotherapy. Specific guidelines and surveillance protocols, similar to those with superficial bladder cancer, are required to determine the role of this adjuvant therapy in the treatment of urothelial tumours of the upper urinary tract. This report shows our experience gained on endoluminal instillation of epidoxorubicin in a selected group of 9 patients who underwent local excission of ureteral or renal pelvis tumours.