The purpose was to propose an update of the french guidelines from the national committee CCAFU on upper tract urothelial carcinomas (UTUC).
A systematic Medline search was performed between 2013 and 2016, as regards diagnosis, options of treatment and follow-up of UTUC, to evaluate different references with levels of evidence.
The diagnosis of this rare pathology is based on CT-scan acquisition during excretion and ureteroscopy with histological biopsies. Radical nephroureterectomy (RNU) remains the gold standard for surgical treatment, nevertheless a conservative endoscopic approach can be proposed for low risk lesion: unifocal tumour, possible complete resection and low grade and absence of invasion on CT-scan. Close monitoring with endoscopic follow-up (flexible ureteroscope) in compliant patients is therefore necessary. After RNU, bladder instillation of chemotherapy is recommended to reduced risk of baldder recurrence. The place of systemic therapy (adjuvant and neoadjuvant chemotherapy) remains to define.
These updated guidelines will contribute to increase the level of urological care for diagnosis and treatment for UTUC. © 2016 Elsevier Masson SAS. All rights reserved.
Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie. 2016 Nov [Epub]
M Rouprêt, P Colin, E Xylinas, E Compérat, F Dubosq, N Houédé, S Larré, A Masson-Lecomte, Y Neuzillet, G Pignot, P Puech, M Roumiguié, A Méjean
Comité de cancérologie de l'Association française d'urologie, groupe vessie, maison de l'urologie, 11, rue Viète, 75017 Paris, France. Electronic address: ., Comité de cancérologie de l'Association française d'urologie, groupe vessie, maison de l'urologie, 11, rue Viète, 75017 Paris, France.