[CCAFU Recommendations 2013: Upper urinary tract carcinoma]

Abstract

Introduction: The objective was to update the guidelines of the French Urological Association Cancer Committee for upper tract urothelial carcinoma (UTUC).

Methods: A Medline search was performed between 2010 and 2013, as regards diagnosis, options of treatment and follow-up of UTUC, to evaluate different references with levels of evidence.

Results: The diagnosis of this rare pathology is based on CT-scan acquisition during excretion and ureteroscopy with histological biopsies. Total nephro-urectomy remains the gold standard for surgical treatment, nevertheless a conservative endoscopic approach can be proposed : unifocal tumour and diameter < 1 cm and low grade and absence of invasion on CT-scan. Close monitoring with endoscopic follow-up (flexible ureteroscope) in compliant patients is therefore necessary.

Conclusion: These new guidelines will hopefully contribute not only to improve patient management, but also diagnosis and treatment for UTUC.

Keywords: Bassinet; Carcinome urothélial haut appareil; Cytologie urinaire; Cytology; Néphrourétérectomie; Radical nephroureterectomy; Renal pelvis; Survie; Survival; Upper tract urothelial carcinoma; Ureter; Ureteroscopy; Uretère; Urétéroscopie.