Morgan Rouprêt1, Marko Babjuk2, Maximilian Burger3, Otakar Capoun4, Daniel Cohen5, Eva M Compérat6, Nigel C Cowan7, Jose L Dominguez-Escrig8, Paolo Gontero9, A Hugh Mostafid10, Joan Palou11, Benoit Peyronnet12, Thomas Seisen13, Viktor Soukup4, Richard J Sylvester14, Bas W G van Rhijn15, Richard Zigeuner16, Shahrokh F Shariat17. 1. Urology, GRC n°5, Predictive ONCO-URO, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne University, Paris, France. Electronic address: morgan.roupret@aphp.fr. 2. Department of Urology, Hospital Motol, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Department of Urology, Medical University of Vienna, Vienna, Austria. 3. Department of Urology, Caritas-St. Josef Medical Center, University of Regensburg, Regensburg, Germany. 4. Urology, General Teaching Hospital and 1st Faculty of Medicine, Charles University Praha, Prague, Czech Republic. 5. Urology, Royal Free London-NHS Foundation Trust, Royal Free Hospital, London, UK. 6. Department of Pathology, Sorbonne University, Assistance Publique-Hôpitaux de Paris, Hopital Tenon, Paris, France. 7. Department of Radiology, The Queen Alexandra Hospital, Portsmouth, UK. 8. Urology, Fundación Instituto Valenciano de Oncología (I.V.O.), Valencia, Spain. 9. Division of Urology, Molinette Hospital, University of Torino School of Medicine, Torino, Italy. 10. Royal Surrey Hospital, Guildford, UK. 11. Department of Urology, Fundacio Puigvert, Universidad Autonoma de Barcelona, Barcelona, Spain. 12. Department of urology, university of Rennes, Rennes, France. 13. Urology, GRC n°5, Predictive ONCO-URO, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne University, Paris, France. 14. EAU Guidelines Office, Arnhem, The Netherlands. 15. Department of Urology, Caritas-St. Josef Medical Center, University of Regensburg, Regensburg, Germany; Department of Surgical Oncology (Urology), Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. 16. Department of Urology, Medical University of Graz, Graz, Austria. 17. Department of Urology, Hospital Motol, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Department of Urology Comprehensive Cancer Centre, Medical University of Vienna, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, NY, USA; Department of Urology, University of Texas Southwestern, Dallas, TX, USA; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
Abstract
CONTEXT: The European Association of Urology (EAU) Guidelines Panel on Upper Urinary Tract Urothelial Carcinoma (UTUC) has prepared updated guidelines to aid clinicians in the current evidence-based management of UTUC and to incorporate recommendations into clinical practice. OBJECTIVE: To provide an overview of the EAU guidelines on UTUC as an aid to clinicians. EVIDENCE ACQUISITION: The recommendations provided in the current guidelines are based on a thorough review of available UTUC guidelines and articles identified following a systematic search of Medline. Data on urothelial malignancies and UTUC were searched using the following keywords: urinary tract cancer, urothelial carcinomas, upper urinary tract carcinoma, renal pelvis, ureter, bladder cancer, chemotherapy, ureteroscopy, nephroureterectomy, neoplasm, adjuvant treatment, instillation, recurrence, risk factors, and survival. References were weighted by a panel of experts. EVIDENCE SYNTHESIS: Owing to the rarity of UTUC, there are insufficient data to provide strong recommendations. The 2017 tumour, node, metastasis (TNM) classification is recommended. Recommendations are given for diagnosis and risk stratification as well as for radical and conservative treatment, and prognostic factors are discussed. A single postoperative dose of intravesical mitomycin after nephroureterectomy reduces the risk of bladder tumour recurrence. Kidney-sparing management should be offered as a primary treatment option to patients with low-risk tumour and two functional kidneys. After radical nephroureterectomy, cisplatin-based chemotherapy is indicated in locally advanced UTUC. CONCLUSIONS: These guidelines contain information on the management of individual patients according to a current standardised approach. Urologists should take into account the specific clinical characteristics of each patient when determining the optimal treatment regimen, based on the proposed risk stratification of these tumours. PATIENT SUMMARY: Urothelial carcinoma of the upper urinary tract is rare, but because 60% of these tumours are invasive at diagnosis, an appropriate diagnosis is most important. A number of known risk factors exist.
CONTEXT: The European Association of Urology (EAU) Guidelines Panel on Upper Urinary Tract Urothelial Carcinoma (UTUC) has prepared updated guidelines to aid clinicians in the current evidence-based management of UTUC and to incorporate recommendations into clinical practice. OBJECTIVE: To provide an overview of the EAU guidelines on UTUC as an aid to clinicians. EVIDENCE ACQUISITION: The recommendations provided in the current guidelines are based on a thorough review of available UTUC guidelines and articles identified following a systematic search of Medline. Data on urothelial malignancies and UTUC were searched using the following keywords: urinary tract cancer, urothelial carcinomas, upper urinary tract carcinoma, renal pelvis, ureter, bladder cancer, chemotherapy, ureteroscopy, nephroureterectomy, neoplasm, adjuvant treatment, instillation, recurrence, risk factors, and survival. References were weighted by a panel of experts. EVIDENCE SYNTHESIS: Owing to the rarity of UTUC, there are insufficient data to provide strong recommendations. The 2017 tumour, node, metastasis (TNM) classification is recommended. Recommendations are given for diagnosis and risk stratification as well as for radical and conservative treatment, and prognostic factors are discussed. A single postoperative dose of intravesical mitomycin after nephroureterectomy reduces the risk of bladder tumour recurrence. Kidney-sparing management should be offered as a primary treatment option to patients with low-risk tumour and two functional kidneys. After radical nephroureterectomy, cisplatin-based chemotherapy is indicated in locally advanced UTUC. CONCLUSIONS: These guidelines contain information on the management of individual patients according to a current standardised approach. Urologists should take into account the specific clinical characteristics of each patient when determining the optimal treatment regimen, based on the proposed risk stratification of these tumours. PATIENT SUMMARY:Urothelial carcinoma of the upper urinary tract is rare, but because 60% of these tumours are invasive at diagnosis, an appropriate diagnosis is most important. A number of known risk factors exist.
Authors: Aadel A Chaudhuri; Bruna Pellini; Nadja Pejovic; Pradeep S Chauhan; Peter K Harris; Jeffrey J Szymanski; Zachary L Smith; Vivek K Arora Journal: JCO Precis Oncol Date: 2020-07-15
Authors: Yun Bai; Jun Lin; An Chen; Min Bai; Chunxiao Li; Yingyu Cai; Jie Yu; Wenjie Hu; Lianfang Du; Fan Li Journal: Br J Radiol Date: 2021-09-03 Impact factor: 3.039
Authors: Dean F Bajorin; J Alfred Witjes; Jürgen E Gschwend; Michael Schenker; Begoña P Valderrama; Yoshihiko Tomita; Aristotelis Bamias; Thierry Lebret; Shahrokh F Shariat; Se Hoon Park; Dingwei Ye; Mads Agerbaek; Deborah Enting; Ray McDermott; Pablo Gajate; Avivit Peer; Matthew I Milowsky; Alexander Nosov; João Neif Antonio; Krzysztof Tupikowski; Laurence Toms; Bruce S Fischer; Anila Qureshi; Sandra Collette; Keziban Unsal-Kacmaz; Edward Broughton; Dimitrios Zardavas; Henry B Koon; Matthew D Galsky Journal: N Engl J Med Date: 2021-06-03 Impact factor: 91.245