European Association of Urology Guidelines on Upper Urinary Tract Urothelial Carcinoma: 2017 Update
European Association of Urology Guidelines on Upper Urinary Tract Urothelial Carcinoma: 2017 Update
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DOI：
10.1016/j.eururo.2017.07.036
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发表时间：
2018-01-01
期刊：
影响因子：
23.4
通讯作者：
Shariat, Shahrokh F.
中科院分区：
文献类型：
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作者：
Roupret, Morgan;Babjuk, Marko;Shariat, Shahrokh F.
内容：欧洲泌尿外科协会（EAU）关于上尿路尿路上皮癌（UTUC）的指南小组已经准备了更新的指南，以帮助临床医生进行当前基于证据的UTUC管理，并将建议纳入临床实践。目的：提供关于UTUC的EAU指南的概述，以帮助临床医生。证据获取：当前指南中提供的建议是基于对现有UTUC指南和Medline系统检索后识别的文章的全面审查。使用以下关键词检索尿路上皮恶性肿瘤和UTUC的数据：尿路癌;尿路上皮癌;上尿路癌;肾盂;输尿管;膀胱癌;化疗;输尿管镜检查;肾输尿管切除术;辅助治疗;灌注;复发;风险因素;和生存期。证据综合：由于UTUC的罕见性，没有足够的数据提供强有力的建议（即A级）。然而，最近的多中心研究的结果现在是可用的，并且在UTUC中有越来越多的回顾性文章。推荐使用2017年肿瘤、淋巴结、转移（TNM）分类。建议的诊断和危险分层，以及为激进和保守治疗，预后因素也进行了讨论。根治性肾输尿管切除术后单次膀胱内灌注丝裂霉素可降低膀胱肿瘤复发的风险。肾脏保留管理应提供作为一个主要的治疗方案，以低风险的肿瘤和两个功能kidney.Conclusions患者：这些指南包含的信息，根据目前的标准化方法的个别患者的管理。泌尿科医生在确定最佳治疗方案时，应根据这些肿瘤的拟议风险分层，考虑每个患者的具体临床特征。(c)2017年欧洲泌尿外科协会。Elsevier B. V.出版，保留所有权利。
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.