保留肾单位手术（NSS）被考虑用于某些上尿路尿路上皮癌（UTUC）病例，因为它可以维持肾功能并避免与根治性肾输尿管切除术（RNU）相关的发病率。鉴于诊断方式的局限性，在不影响肿瘤学结果的情况下适当选择适合 NSS 的患者有时可能很困难。 NSS 后 UTUC 的复发率可高达 36% 至 54%。 NSS 后可尝试腔内辅助治疗以减少复发，但输送到上尿路比输送到膀胱更具挑战性。卡介苗 (BCG) 和丝裂霉素 (MMC) 等化疗药物通过肾造口术或输尿管导管给药，这需要对上尿路进行侵入性/重复器械操作。还尝试过通过膀胱灌注沿留置支架回流进行药物输送，但可能不可靠。最近，已开发出一种丝裂霉素凝胶制剂，用于在数小时内控制上尿路的治疗暴露。用于将化疗药物输送到上尿路的药物洗脱支架已经开发出来，但尚未进入临床实践。利用静脉内光敏剂的腔内光疗是最近描述的另一种新方法。腔内治疗可能有助于降低 UTUC 的复发率，但目前其使用存在一些限制。

Nephron sparing surgery (NSS) is considered for selected cases of upper tract urothelial carcinoma (UTUC) as it maintains renal function and avoids morbidity associated with radical nephroureterectomy (RNU). The appropriate selection of patients suitable for NSS without compromising oncological outcomes can sometimes be difficult, given the limitations of diagnostic modalities. Recurrence rates for UTUC can be as high as 36 to 54% after NSS. Intraluminal adjuvant therapy can be attempted following NSS to reduce recurrence, but delivery to the upper tract is more challenging than into the bladder. Bacillus Calmette-Guerin (BCG) and chemotherapy such as Mitomycin (MMC) have been administered via nephrostomy or ureteric catheter, which requires invasive/repeated instrumentation of the upper urinary tract. Drug delivery by reflux from bladder instillation along indwelling stents has also been tried but can potentially be unreliable. Recently, a gel formulation of mitomycin has been developed for the controlled exposure of the upper urinary tract to treatment over a number of hours. Drug-eluting stents to deliver chemotherapy to the upper urinary tract have been developed but have not yet entered clinical practice. Endoluminal phototherapy utilising an intravenous photosensitising agent is another novel approach that has recently been described. Intraluminal therapies may be beneficial in decreasing recurrence rates in UTUC, but currently have some limitations in their usage.