Abstract:
INTRODUCTION: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. METHODS: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. RESULTS: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. CONCLUSIONS: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.
journal_name
World J Uroljournal_title
World journal of urologyauthors
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 SFdoi
10.1007/s00345-016-1859-6subject
Has Abstractpub_date
2017-03-01 00:00:00pages
355-365issue
3eissn
0724-4983issn
1433-8726pii
10.1007/s00345-016-1859-6journal_volume
35pub_type
杂志文章,评审abstract:PURPOSE:The Grade Group (GG) classification is recommended by guidelines as a reliable prognostic factor of prostate cancer. However, most studies have been performed on the Caucasian population. Our objective was to validate GG classification as a safe way to classify intermediate- and high-risk patients with African ...
journal_title:World journal of urology
pub_type: 杂志文章
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journal_title:World journal of urology
pub_type: 杂志文章
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journal_title:World journal of urology
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journal_title:World journal of urology
pub_type: 杂志文章
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journal_title:World journal of urology
pub_type: 临床试验,杂志文章
doi:10.1007/BF00184874
更新日期:1995-01-01 00:00:00
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journal_title:World journal of urology
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journal_title:World journal of urology
pub_type: 杂志文章,多中心研究
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更新日期:2011-02-01 00:00:00
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journal_title:World journal of urology
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更新日期:2015-01-01 00:00:00
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journal_title:World journal of urology
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journal_title:World journal of urology
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journal_title:World journal of urology
pub_type: 杂志文章
doi:10.1007/s00345-007-0193-4
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journal_title:World journal of urology
pub_type: 杂志文章
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更新日期:2003-05-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2018-12-01 00:00:00
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journal_title:World journal of urology
pub_type: 传,历史文章,杂志文章
doi:10.1007/s003450050125
更新日期:1999-06-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章
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更新日期:2013-04-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章,评审
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更新日期:1996-01-01 00:00:00
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journal_title:World journal of urology
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journal_title:World journal of urology
pub_type: 杂志文章
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journal_title:World journal of urology
pub_type: 杂志文章
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更新日期:2011-06-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章
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更新日期:2013-10-01 00:00:00
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pub_type: 杂志文章
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更新日期:2019-12-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章,评审
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更新日期:2020-04-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章
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更新日期:2003-11-01 00:00:00
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pub_type: 杂志文章
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更新日期:2010-02-01 00:00:00