Update of the ICUD-SIU consultation on upper tract urothelial carcinoma 2016: treatment of low-risk upper tract urothelial carcinoma
Por:
Mandalapu, RS, Remzi, M, de Reijke, TM, Margulis, V, Palou, J, Kapoor, A, Yossepowitch, O, Coleman, J, Traxer, O, Anderson, JK, Catto, J, de la Rosette, J, O'Brien, T, Zlotta, A, Matin, S
Publicada:
1 mar 2017
Resumen:
The conservative management of upper tract urothelial carcinoma (UTUC) has historically been offered to patients with imperative indications. The recent International Consultation on Urologic Diseases (ICUD) publication on UTUC stratified treatment allocations based on high- and low-risk groups. This report updates the conservative management of the low-risk group.
The ICUD for low-risk UTUC working group performed a thorough review of the literature with an assessment of the level of evidence and grade of recommendation for a variety of published studies in this disease space. We update these publications and provide a summary of that original report.
There are no prospective randomized controlled studies to support surgical management guidelines. A risk-stratified approach based on clinical, endoscopic, and biopsy assessment allows selection of patients who could benefit from kidney-preserving procedures with oncological outcomes potentially similar to radical nephroureterectomy with bladder cuff excision, with the added benefit of renal function preservation. These treatments are aided by the development of high-definition flexible digital URS, multi-biopsies with the aid of access sheaths and other tools, and promising developments in the use of adjuvant topical therapy.
Recent developments in imaging, minimally invasive techniques, multimodality approaches, and adjuvant topical regimens and bladder cancer prevention raise the hope for improved risk stratification and may greatly improve the endoscopic treatment for low-risk UTUC.
Filiaciones:
Remzi, M:
LKH Korneuburg, Korneuburg, Austria
de Reijke, TM:
AMC Univ Hosp, Amsterdam, Netherlands
Margulis, V:
Univ Texas Southwestern, Dept Urol, Dallas, TX USA
Palou, J:
Fdn Puigvert, Barcelona, Spain
Kapoor, A:
McMaster Univ, Hamilton, ON, Canada
Yossepowitch, O:
Tel Aviv Univ, Rabin Med Ctr, Tel Aviv, Israel
Coleman, J:
Mem Sloan Kettering Canc Ctr, Dept Urol, 1275 York Ave, New York, NY 10021 USA
Traxer, O:
Univ Pierre & Marie Curie Paris 6, Hop Tenon, Paris, France
Anderson, JK:
Univ Minnesota, Med Ctr, Minneapolis, MN 55455 USA
Catto, J:
Univ Sheffield, Acad Urol Unit, Sheffield, S Yorkshire, England
de la Rosette, J:
AMC Univ Hosp, Amsterdam, Netherlands
O'Brien, T:
Guys & St Thomas NHS Fdn Trust, London, England
Zlotta, A:
Mt Sinai Hosp, Toronto, ON, Canada
Matin, S:
Univ Texas MD Anderson Canc Ctr, Dept Urol, 1515 Holcombe Blvd,Unit 1373, Houston, TX 77030 USA
Green Accepted
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