Urothelial carcinoma

Our understanding of urothelial carcinoma (UC) has advanced significantly over the past three decades to provide a better understanding of the molecular basis of these tumors and the different clinical behaviors of low-and high-grade urothelial carcinoma. Fluorescence in situ hybridization is currently used to monitor UC patients for recurrent tumor and to detect new bladder tumors in patients with hematuria. The detection of cells with FGFR3 mutations in urine shows promise as a way to detect low-grade UC. Assessing upper urinary tract UC for defective mismatch repair with microsatellite instability testing or immunostains for MLH1, PMS2, MSH2, and MSH6 helps identify patients that may have Lynch syndrome. While targeted therapies are being investigated for use in advanced bladder cancer, progress has been slow and molecular profiling of urothelial carcinoma for guiding targeted therapy of UC is not currently clinically indicated.