Current laser therapy options for endoscopic treatment of upper tract urothelial carcinoma

Benjamin W Zollinger; Ezra J Shoen; Charles F Gresham; Michael J Whalen

doi:10.1097/CU9.0000000000000158

Current laser therapy options for endoscopic treatment of upper tract urothelial carcinoma

Curr Urol. 2023 Mar;17(1):62-67. doi: 10.1097/CU9.0000000000000158. Epub 2022 Oct 10.

Authors

Benjamin W Zollinger¹, Ezra J Shoen², Charles F Gresham³, Michael J Whalen³

Affiliations

¹ George Washington School of Medicine and Health Sciences, Washington, DC, USA.
² Department of Urology, Icahn School of Medicine, Mount Sinai Hospital, New York, NY, USA.
³ Department of Urology, George Washington University Hospital, Washington, DC, USA.

Abstract

Endoscopic management via retrograde ureteroscopic laser ablation of upper tract urothelial carcinoma (UTUC) has become the preferred treatment modality for low-risk tumors. The most popular ablative lasers over the past 15-20 years have been the holmium:yttrium-aluminum-garnet (Ho:YAG) and neodymium (Nd:YAG) lasers, but recently the thulium (Th:YAG) laser has emerged as a potential alternative. This review compares the mechanism of action, physiological properties and effects, and oncologic outcomes of Ho:YAG/Nd:YAG lasers versus the Th:YAG laser for UTUC treatment. Potential advantages of the Th:YAG laser over existing technologies are outlined, followed by a discussion of emerging laser technologies in UTUC management.

Keywords: Endoscopic management; Holmium laser; Laser ablation; Thulium laser; Upper tract urothelial carcinoma.