European Association of Urology Guidelines on Upper Urinary Tract Urothelial Carcinoma: 2017 Update
Por:
Roupret, M, Babjuk, M, Comperat, E, Zigeuner, R, Sylvester, RJ, Burger, M, Cowan, NC, Gontero, P, Van Rhijn, BWG, Mostafid, AH, Palou, J, Shariat, SF
Publicada:
1 ene 2018
Resumen:
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.
Filiaciones:
Roupret, M:
Hop La Pitie Salpetriere, AP HP, Serv Urol, Paris, France
UPMC Univ Paris 06, GRC5, ONCOTYPE Uro, Inst Univ Cancerol, Paris, France
Babjuk, M:
Charles Univ Prague, Fac Med 2, Hosp Motol, Dept Urol, Prague, Czech Republic
Comperat, E:
UPMC Paris VI, Hop Tenon, AP HP, Dept Pathol, Paris, France
Zigeuner, R:
Med Univ Graz, Dept Urol, Graz, Austria
Sylvester, RJ:
European Assoc Urol, Guidelines Off, Brussels, Belgium
Burger, M:
Univ Regensburg, Caritas St Josef Med Ctr, Dept Urol, Regensburg, Germany
Cowan, NC:
Queen Alexandra Hosp, Dept Radiol, Portsmouth, Hants, England
Gontero, P:
Univ Studies Torino, Molinette Hosp, Div Urol, Dept Surg Sci, Turin, Italy
Van Rhijn, BWG:
Antoni van Leeuwenhoek Hosp, Netherlands Canc Inst, Dept Surg Oncol Urol, Amsterdam, Netherlands
Mostafid, AH:
Royal Surrey Cty Hosp, Dept Urol, Guildford, Surrey, England
Palou, J:
Univ Autonoma Barcelona, Dept Urol, Fundacio Puigvert, Barcelona, Spain
Shariat, SF:
Med Univ Vienna, Vienna Gen Hosp, Dept Urol, Vienna, Austria
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