European Association of Urology Guidelines on Upper Urinary Tract Urothelial Carcinoma: 2017 Update

被引:663
作者
Roupret, Morgan [1 ,2 ]
Babjuk, Marko [3 ]
Comperat, Eva [4 ]
Zigeuner, Richard [5 ]
Sylvester, Richard J. [6 ]
Burger, Maximilian [7 ]
Cowan, Nigel C. [8 ]
Gontero, Paolo [9 ]
Van Rhijn, Bas W. G. [10 ]
Mostafid, A. Hugh [11 ]
Palou, Joan [12 ]
Shariat, Shahrokh F. [13 ]
机构
[1] Hop La Pitie Salpetriere, AP HP, Serv Urol, Paris, France
[2] UPMC Univ Paris 06, GRC5, ONCOTYPE Uro, Inst Univ Cancerol, Paris, France
[3] Charles Univ Prague, Fac Med 2, Hosp Motol, Dept Urol, Prague, Czech Republic
[4] UPMC Paris VI, Hop Tenon, AP HP, Dept Pathol, Paris, France
[5] Med Univ Graz, Dept Urol, Graz, Austria
[6] European Assoc Urol, Guidelines Off, Brussels, Belgium
[7] Univ Regensburg, Caritas St Josef Med Ctr, Dept Urol, Regensburg, Germany
[8] Queen Alexandra Hosp, Dept Radiol, Portsmouth, Hants, England
[9] Univ Studies Torino, Molinette Hosp, Div Urol, Dept Surg Sci, Turin, Italy
[10] Antoni van Leeuwenhoek Hosp, Netherlands Canc Inst, Dept Surg Oncol Urol, Amsterdam, Netherlands
[11] Royal Surrey Cty Hosp, Dept Urol, Guildford, Surrey, England
[12] Univ Autonoma Barcelona, Dept Urol, Fundacio Puigvert, Barcelona, Spain
[13] Med Univ Vienna, Vienna Gen Hosp, Dept Urol, Vienna, Austria
关键词
Urothelial carcinoma; Urinary tract cancer; Risk factors; Ureter; Renal pelvis; Cytology; Ureteroscopy; Nephroureterectomy; Survival; Guidelines; INVASIVE BLADDER-CANCER; RADICAL NEPHROURETERECTOMY; ONCOLOGIC OUTCOMES; INTRAVESICAL RECURRENCE; NEOADJUVANT CHEMOTHERAPY; PROGNOSTIC-FACTOR; CELL CARCINOMAS; TUMOR LOCATION; CUFF EXCISION; IMPACT;
D O I
10.1016/j.eururo.2017.07.036
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
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; 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 (ie, grade A). However, the results of recent multicentre studies are now available, and there is a growing number of retrospective articles in UTUC. 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; prognostic factors are also discussed. A single postoperative dose of intravesical mitomycin after radical nephroureterectomy reduces the risk of bladder tumour recurrence. Kidney-sparing management should be offered as a primary treatment option to patients with low-risk tumours and two functional kidneys. 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. (c) 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:111 / 122
页数:12
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