Abstract
Upper urinary tract cancer requires radical nephro-ureterectomy as standard surgical therapy. Endoscopic surgery is recommended for only low-stage and low-grade cancer, as recommendation grade B. We herein report 3 cases of noninvasive, low-grade ureteral cancer treated by intravesical perfusion of pirarubicin with ureteral stent placement post trans-urethral resection of a ureteral tumor（TURUT）. Six-eight weekly perfusions of pirarubicin at 40 mg were performed as possible. The 3 cases included 1 elective case and 2 imperative cases. Pathological findings in TURUT specimens revealed noninvasive papillary urothelial carcinoma, low-grade pTa-1 in all cases. One patient, case 3, had bladder recurrence 23 months after TURUT, but all patients, cases 1, 2, 3, have remained alive and experienced no recurrence in the cancer-side ureter for 43, 32, and 28 months, respectively. Pirarubicin perfusion post TUR for upper urinary tract noninvasive, low-grade urothelial tumors is tolerable and may prevent cancer recurrence, and also may prevent imperative cases with renal failure from requiring dialysis.
