{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T16:48:48Z","timestamp":1754153328082,"version":"3.41.2"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aktuelle Urol"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n    Das Urothelkarzinom des oberen Harntrakts (\u201eupper tract urothelial carcinoma\u201c, UTUC) stellt eine seltene Tumorerkrankung dar, die h\u00e4ufig erst in fortgeschrittenen Stadien diagnostiziert wird. Die Diagnostik basiert auf einer CT-Urografie, Sp\u00fclzytologie aus dem oberen Harntrakt und einer Ureterorenoskopie (URS). Die Risikostratifizierung in eine Low- und High-Risk-UTUC dient als Grundlage f\u00fcr die Therapieentscheidung. Beim High-Risk-UTUC stellt die radikale Nephroureterektomie (RNU) mit Blasenmanschettenresektion den operativen Standard dar, wobei in selektionierten F\u00e4llen auch nierenerhaltene Verfahren erwogen werden k\u00f6nnen. Da die RNU einen signifikanten R\u00fcckgang der Nierenfunktion mit sich bringt und erste prospektive Daten eine gute radiologische und pathologische Remissionsrate zeigen, wird die neoadjuvante Chemotherapie beim UTUC zunehmend diskutiert. Der Behandlungsstandard hingegen f\u00fcr Tumoren im pT2\u2013pT4-Stadium oder bei einem positiven Lymphknotenstatus (pN+) ist die adjuvante platinbasierte Kombinationschemotherapie, sofern diese nicht bereits als neoadjuvante Therapie erfolgt ist. Die adjuvante Immuntherapie mit Nivolumab zeigte in der UTUC-Kohorte im Vergleich zum Harnblasenkarzinom keinen signifikanten Therapievorteil und sollte nur Patienten im Tumorstadium \u2265pT3 und\/oder pN+ (oder \u2265ypT2 und\/oder ypN+ nach neoadjuvanter Chemotherapie) angeboten werden, die f\u00fcr eine platinbasierte Kombinationschemotherapie ungeeignet sind oder diese ablehnen.\n    <\/jats:p>","DOI":"10.1055\/a-2504-4215","type":"journal-article","created":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T19:07:21Z","timestamp":1739387241000},"page":"334-339","source":"Crossref","is-referenced-by-count":0,"title":["Therapie des high-risk Urothelkarzinoms des oberen Harntraktes"],"prefix":"10.1055","volume":"56","author":[{"given":"Yanchun","family":"Ma","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Urologie und Kinderurologie, Universit\u00e4tsklinikum Ulm, Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Friedemann","family":"Zengerling","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Urologie und Kinderurologie, Universit\u00e4tsklinikum Ulm, Ulm, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,2,12]]},"reference":[{"isbn-type":"print","volume-title":"AU Guidelines on Upper Urinary Tract Urothelial Cell Carcinoma. 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