M Rouprêt1, E Xylinas2, P Colin3, N Houédé4, E Compérat5, F Audenet6, S Larré7, A Masson-Lecomte8, G Pignot9, S Brunelle10, M Roumiguié11, Y Neuzillet12, A Méjean6. 1. Comité de cancérologie de l'Association française d'urologie, groupe vessie, Maison de l'Urologie, 11, rue Viète, 75017 Paris, France; GRC n(o) 5, ONCOTYPE-URO, hôpital Pitié-Salpêtrière, Sorbonne université, AP-HP, 75013 Paris, France. Electronic address: morgan.roupret@aphp.fr. 2. Comité de cancérologie de l'Association française d'urologie, groupe vessie, Maison de l'Urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie, hôpital Bichat-Claude-Bernard, université Paris-Descartes, AP-HP, 75018 Paris, France. 3. Comité de cancérologie de l'Association française d'urologie, groupe vessie, Maison de l'Urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie, hôpital privé de la Louvière, 59042 Lille, France. 4. Comité de cancérologie de l'Association française d'urologie, groupe vessie, Maison de l'Urologie, 11, rue Viète, 75017 Paris, France; Département d'oncologie Médicale, CHU Caremaux, Montpellier université, 30029 Nîmes, France. 5. Comité de cancérologie de l'Association française d'urologie, groupe vessie, Maison de l'Urologie, 11, rue Viète, 75017 Paris, France; Service d'anatomie pathologique, GRC n(o) 5, ONCOTYPE-URO, hôpital Tenon, HUEP, Sorbonne université, AP-HP, 75020 Paris, France. 6. Comité de cancérologie de l'Association française d'urologie, groupe vessie, Maison de l'Urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie, hôpital Européen-Georges-Pompidou, université Paris Descartes, AP-HP, 75015 Paris, France. 7. Comité de cancérologie de l'Association française d'urologie, groupe vessie, Maison de l'Urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie, CHU de Reims, 51100 Reims, France. 8. Comité de cancérologie de l'Association française d'urologie, groupe vessie, Maison de l'Urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie, hôpital Saint-Louis, université Paris-Diderot, AP-HP, 75010 Paris, France. 9. Comité de cancérologie de l'Association française d'urologie, groupe vessie, Maison de l'Urologie, 11, rue Viète, 75017 Paris, France; Service de chirurgie oncologique 2, institut Paoli-Calmettes, 13009 Marseille, France. 10. Comité de cancérologie de l'Association française d'urologie, groupe vessie, Maison de l'Urologie, 11, rue Viète, 75017 Paris, France; Service de radiologie, institut Paoli-Calmettes, 13009 Marseille, France. 11. Comité de cancérologie de l'Association française d'urologie, groupe vessie, Maison de l'Urologie, 11, rue Viète, 75017 Paris, France; Département d'urologie, CHU Rangueil, 31400 Toulouse, France. 12. Comité de cancérologie de l'Association française d'urologie, groupe vessie, Maison de l'Urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie, hôpital Foch, université de Versailles-Saint-Quentin-en-Yvelines, 92150 Suresnes, France.
Abstract
INTRODUCTION: To propose an update of the French guidelines from the national committee ccAFU on upper tract urothelial carcinomas (UTUC). METHODS: A systematic Medline search was performed between 2016 and 2018, with regards to the diagnosis, the options of treatment and the follow-up of UTUC, to evaluate the different studies with levels of evidence. RESULTS: The diagnosis of this rare disease is based on CT-scan acquisition during excretion and ureteroscopy with histological biopsies. Radical nephroureterectomy (RNU) remains the gold standard for surgical treatment, nevertheless a conservative endoscopic approach can be proposed for low-risk diseases: unifocal tumour, possible complete resection low-grade and lack of invasion on CT-scan. Close monitoring with endoscopic follow-up (flexible ureteroscopy) in compliant patients is therefore necessary. After RNU, bladder instillation of chemotherapy is recommended in order to reduce the risk of bladder recurrence. An adjuvant chemotherapy is recommended after RNU in pT2-T4 N0-3 M0 disease. CONCLUSION: These updated guidelines will contribute to increase the level of urological care for diagnosis and treatment of UTUC.
INTRODUCTION: To propose an update of the French guidelines from the national committee ccAFU on upper tract urothelial carcinomas (UTUC). METHODS: A systematic Medline search was performed between 2016 and 2018, with regards to the diagnosis, the options of treatment and the follow-up of UTUC, to evaluate the different studies with levels of evidence. RESULTS: The diagnosis of this rare disease is based on CT-scan acquisition during excretion and ureteroscopy with histological biopsies. Radical nephroureterectomy (RNU) remains the gold standard for surgical treatment, nevertheless a conservative endoscopic approach can be proposed for low-risk diseases: unifocal tumour, possible complete resection low-grade and lack of invasion on CT-scan. Close monitoring with endoscopic follow-up (flexible ureteroscopy) in compliant patients is therefore necessary. After RNU, bladder instillation of chemotherapy is recommended in order to reduce the risk of bladder recurrence. An adjuvant chemotherapy is recommended after RNU in pT2-T4 N0-3 M0 disease. CONCLUSION: These updated guidelines will contribute to increase the level of urological care for diagnosis and treatment of UTUC.
Authors: Jan T Klein; Axel John; Lars Bohnert; Markus D Enderle; Walter Linzenbold; Christian Bolenz Journal: Front Oncol Date: 2022-02-11 Impact factor: 6.244
Authors: A Méjean; M Rouprêt; F Rozet; K Bensalah; T Murez; X Game; X Rebillard; R Mallet; A Faix; P Mongiat-Artus; G Fournier; Y Neuzillet Journal: Prog Urol Date: 2020-03-30 Impact factor: 0.915