Abstract
This thesis focuses on the outcome of diagnosis and treatment of urothelial cell carcinoma (UCC). Depending on the location it is mentioned bladder cancer respectively Upper Urinary Tract Tumor (UUTT).
The first part of this thesis attends to bladder cancer care in different regions of the Netherlands at the time that only European and American guidelines were available. The pattern of care for patients with high risk Non Muscle Invasive Bladder Carcinoma (NMIBC) as well as Muscle Invasive Bladder Cancer (MIBC) are evaluated to assess the impact of patient-, tumor- and doctor-related factors on treatment choices and treatment outcome. Increasing age and more comorbidity seem to be important determinating factors for not undergoing the recommended treatment.
The second part of the thesis deals with the visualization of the upper urinary tract (UUT) with regard to the diagnosis and treatment of UUTT. The history and background of the different urographic techniques are discussed in detail. Today CT scanning with intravenous contrast (CTU) is most frequently used. Although not routinely performed in most urological clinics, Retrograde Ureteric Pyelography (RUP) still plays a significant role in our center, especially because of the excellent X-ray facilities during the last four decennia. One study evaluates the feasibility and efficacy of RUP in the diagnosis of UCC of the UUT and compares the grade of opacification of RUP with that of CTU. The second one focuses on the early detection of UUTT using RUP urography in patients with proven urothelial cell carcinoma.
The first part of this thesis attends to bladder cancer care in different regions of the Netherlands at the time that only European and American guidelines were available. The pattern of care for patients with high risk Non Muscle Invasive Bladder Carcinoma (NMIBC) as well as Muscle Invasive Bladder Cancer (MIBC) are evaluated to assess the impact of patient-, tumor- and doctor-related factors on treatment choices and treatment outcome. Increasing age and more comorbidity seem to be important determinating factors for not undergoing the recommended treatment.
The second part of the thesis deals with the visualization of the upper urinary tract (UUT) with regard to the diagnosis and treatment of UUTT. The history and background of the different urographic techniques are discussed in detail. Today CT scanning with intravenous contrast (CTU) is most frequently used. Although not routinely performed in most urological clinics, Retrograde Ureteric Pyelography (RUP) still plays a significant role in our center, especially because of the excellent X-ray facilities during the last four decennia. One study evaluates the feasibility and efficacy of RUP in the diagnosis of UCC of the UUT and compares the grade of opacification of RUP with that of CTU. The second one focuses on the early detection of UUTT using RUP urography in patients with proven urothelial cell carcinoma.
| Translated title of the contribution | Urotheelcel Carcinoom: Zorgpatronen en hedendaagse urografie |
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| Original language | English |
| Qualification | Doctor of Philosophy |
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| Supervisors/Advisors |
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| Award date | 29-Oct-2014 |
| Publisher | |
| Print ISBNs | 978-90-367-7200-6 |
| Electronic ISBNs | 978-90-367-7199-3 |
| Publication status | Published - 2014 |