(UroToday.com) Upper tract urothelial carcinoma (UTUC) is a relatively rare malignancy, comprising a small subset of urothelial disease. Compared to bladder cancer, endoscopic management of UTUC and intraluminal therapy is substantially more difficult. As a result, organ-preserving treatments are technically difficult. Thus, these approaches are often reserved for easily accessible, small, low-grade tumors. In part due to these nuances of treatment and in part due to underlying disease biology, UTUC has a relatively high recurrence and progression risk. Unfortunately, currently utilized methods of surveillance including cytology and imaging have low sensitivity and repeated ureteroscopy is invasive and costly. However, circulating tumor DNA (ctDNA) analysis using digital polymerase chain reaction (dPCR) has demonstrated promising results for monitoring of several types of cancers. This approach is noninvasive, highly-sensitive, and low-cost.