{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:10:09Z","timestamp":1772169009930,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/f1000research.55516.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T00:00:00Z","timestamp":1687737600000}}],"reference-count":18,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T00:00:00Z","timestamp":1687737600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>\n                    <ns3:bold>Background:<\/ns3:bold>\n                    Upper tract urothelial carcinoma (UTUC) is a malignant disease of the urothelial cell lining the upper urinary tract from renal calyces, pelvises, and ureter down to the ureteral orifice. Urothelial carcinoma is a multifocal malignant tumor which tends to reoccur after treatment. Radical cystectomy shows that upper tract recurrence occurs in 0.75% to 6.4% of patients. The occurrence of contralateral UTUC after nephroureterectomy is rarer with a prevalence of 0.5%.\n                  <\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>Case presentation:<\/ns3:bold>\n                    The case of a 43-year-old male with metachronous bilateral UTUC was reported. The patient had undergone gemcitabine-cysplatine neoadjuvant chemotherapy followed by radical cystectomy and orthotopic neobladder for urothelial carcinoma of the bladder cT2N0M0. Left hydronephrosis was discovered three months after the procedure. The patient was diagnosed with left UTUC cT4N0M0 of renal pyelum after a series of examinations. A left open radical nephroureterectomy was conducted to remove the mass followed by adjuvant chemotherapy. This was followed up with routine ultrasound and magnetic resonance imaging (MRI) every three months with a \u201ctumor-free\u201d period of 26 months. Meanwhile, the patient was re-admitted with fever and an increase in creatinine value of 4.3. After further workups, the patient was diagnosed with UTUC cT2N0M0 of the right renal pyelum. A kidney sparring approach with laser evaporation of the tumor was conducted followed by eight cycles of Gemcitabine intracavity antegrade per nephrostomy. After the regimen was finished, an MRI evaluation was conducted to assess treatment results, and the mass had decreased.\n                  <\/ns3:p>\n                  <ns3:p>\n                    <ns3:bold>Conclusions:<\/ns3:bold>\n                    This report showed a rare case of urothelial cell carcinoma recurrences. From bladder urothelial carcinoma to left UTUC and then to contralateral UTUC. It is important to evaluate the upper tract to reduce the risk of recurrence.\n                  <\/ns3:p>","DOI":"10.12688\/f1000research.55516.2","type":"journal-article","created":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T05:46:17Z","timestamp":1687758377000},"page":"778","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Metachronous bilateral upper tract and bladder urothelial carcinoma: a long-term follow-up"],"prefix":"10.12688","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7538-2811","authenticated-orcid":false,"given":"Agus Rizal Ardy Hariandy","family":"Hamid","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4241-6912","authenticated-orcid":false,"given":"Fakhri Zuhdian","family":"Nasher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meilania","family":"Saraswati","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7886-404X","authenticated-orcid":false,"given":"Sahat","family":"Matondang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chaidir","family":"Arif Mochtar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2023,6,26]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"7-34","DOI":"10.3322\/caac.21551","article-title":"Cancer statistics, 2019.","volume":"69","author":"R Siegel","year":"2019","journal-title":"CA Cancer J 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status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.59097.r95637, Alcides Chaux, Department of Scientific Research, Norte University, Asunci\u00f3n, 04 Nov 2021, version 1, 1 approved, 1 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/10-778\/v1#referee-response-95637","order":0,"name":"referee-response-95637","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.59097.r129088, Mohamed Mohamed Elawdy, Urology Department, Sohar Hospital, Ministry of Health, Sohar, 12 Apr 2022, version 1, 1 approved, 1 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/10-778\/v1#referee-response-129088","order":1,"name":"referee-response-129088","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Agus Rizal Ardy Hariandy Hamid<\/b>; \n<i>Posted: 10 Nov 2022<\/i>; Thank you for the comments, the following are our responses to the review:  &quot;Radical cystectomy shows that upper tract recurrence occurs in 0.75% to 6.4% of patients.&quot; Please elaborate on this sentence.  Upper urinary tract disease may develop in the residual transitional tissue in patients who have radical cystectomy for urothelial carcinoma. The odd of this recurrence is rare, especially after a radical cystectomy. A meta-analysis of 27 studies showed that the incidence of UTUC ranged from 0.75% to 6.4%. Numerous risk factors for upper urinary tract recurrence have been found in previous studies, however, it is still debatable how well each one predicts future occurrences.  &quot;Upper tract urothelial carcinoma (UTUC) is a malignant disease of the urothelial cell lining the upper urinary tract from renal calyces, pelvises, and ureter down to ureteral orifice.&quot; This is a complicated sentence, instead perhaps you can write: &quot;from the renal calyces or collecting system to the ureteral orifice.&quot;  Thank you for your constructive feedback. Yes, we will paraphrase to: \u201cUpper tract urothelial carcinoma (UTUC) is a malignant disease of the urothelial cell lining the upper urinary tract from the renal calyces or collecting system to the ureteral orifice.&quot;  If the case is a UTUC after bladder cancer, why did you deal with contralateral UTUC after nephroureterectomy to such a degree?  This is the reason why we present this rare case of multiple event recurrence of UTUC which possible to make a second tumor arise in another site with the urothelial cell as its lining  If you mention a case with multiple events, it is best practice to start with the most recent, then to mention the past history. Additionally, there is&nbsp;too much focus on the details of the patient\u2019s habits.  Well noted, thank you for the feedback  &quot;An abdominal MRI with contrast was performed (Figure 3a). Furthermore, left nephrostomy and biopsy were conducted and pathology workup showed papillary arranged tumor mass.&quot; Why left nephrostomy for a biopsy? Why did you not get it with URS?  Thank you for your question, we would like to clarify that the nephrostomy mentioned in the line above was related to the management of the hydronephrosis of the left kidney that is more severe. The biopsy itself was done via URS  Figure 2. &quot;(a) Contrast computed tomography (CT) scan in December 2019 showing isodens mass that enhanced after contrast administration in the bladder. (b) Ultrasound in March 2020. An isoechoic lesion with irregular edges, on the left inferolateral bladder wall, and appears to be obstructing the left ureter with its distal part dilated.&quot; Please correct, figure (a) is the ultrasound.  Well noted, thank you for the correction, we will swap the picture in Figure 2  Figure 3. &quot;(a) Abdominal magnetic resonance imaging (MRI) with Gadobutrol 5 ml contrast, shown hyper- intense lesions were seen on T1-T2WI and FS on the left intrapelviocalyceal and extracapsular perirenal, which were enhanced after the contrast was administered. (b) High-grade infiltrative urothelial carcinoma.&quot; Please correct, figure (b) is the MRI.  Both Figure 3 (a) and (b) are the Abdominal MRI with different planes (axial and coronal view)  Furthermore, a routine ultrasound and MRI were followed up every three months, and the indwelling catheter was replaced every two weeks.&quot; Imaging is every 6 months, so why it was done every 3 months? What do you mean by indwelling catheter was replaced every two weeks?  After a cystectomy, some patients who are at a higher risk of recurrence might benefit from stricter upper tract surveillance. Early diagnosis of recurrent disease allows for prompt administration of the proper therapy and may even enhance patient outcomes. Regular computerized tomography with urography enables the investigation of the upper urinary system from an oncological and functional perspective as well as the detection of any recurrence. (1) The indwelling catheter is regularly changed to reduce the risk of Ca-UTI. The timing of catheter changes should be individualized. (1) Picozzi S, Ricci C, Gaeta M, Ratti D, Macchi A, Casellato S, Bozzini G, Carmignani L. Upper urinary tract recurrence following radical cystectomy for bladder cancer: a meta-analysis on 13,185 patients. The Journal of urology. 2012 Dec 1;188(6):2046-54.  What do you mean by Karnofsky score of 90?  According to Crooks et al., The Karnofsky Performance Scale Index allows patients to be classified as to their functional impairment. This can be used to compare the effectiveness of different therapies and to assess the prognosis in individual patients. In this setting, Karnofsky Score 90 means the patient is still able to carry on the normal activity with minor signs or symptoms of the disease. (Crooks, V, Waller S, et al. The use of the Karnofsky Performance Scale in determining outcomes and risk in geriatric outpatients. J Gerontol. 1991; 46: M139-M144)  &quot;...right renal pyelum&quot; This should be written as renal pelvis.  Noted, thank you for the correction  &quot;In addition, a puncture was made in the right flank to the superior calyx guided by fluoroscopy into the pelvicalyceal system during the surgery. A nephroscope was then inserted, which exposed a tumor on the right pyelum sized about 3 cm.&quot; Taking a biopsy by puncturing the kidney is not a standard. Why was this done? You can give a rational saying being a tumor in solitary kidney or so.  Thank you for your comment, many recommend the ureteroscopic approach in the case of tumor biopsy. In the case a tumor in solitary kidney or a large tumors that would require long operatory time or even multiple procedures for a complete treatment, the antegrade approach is preferred. In this case, the tumor was then extracted using forceps for biopsy, and the residue was evaporated using a laser.  &quot;Furthermore, nephroscope post-laser ablation examination shows some tumor residue (Figure 4b). The biopsy result was a urothelial carcinoma infiltrative high grade.&quot; Can you mention the pathology clearly, was it non-muscle or muscle invasive?  Muscle invasive  Overall, the discussion is very long for a case report, please shorten as much as possible.  Well noted, thank you for your kind feedback  You should generally have a message from the case report, and the only massage is treating UTUC in a single kidney with resection and BCG. This is the rationale for this case to be accepted. Focus on this point and bring similar studies and make the discussion mainly on this point.  Thank you for your constructive feedback related to our article\/manuscript","URL":"https:\/\/f1000research.com\/articles\/10-778\/v2#referee-comment-9010","order":2,"name":"referee-comment-9010","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.151899.r363533, Katsuhiro Ito, Department of Urology, Ijinkai Takeda General Hospital, Ishida Fushimi-ku, Kyoto, 13 Feb 2025, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/10-778\/v2#referee-response-363533","order":3,"name":"referee-response-363533","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":4,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}