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EAU Guidelines pro diagnostiku a léčbu uroteliálního karcinomu horních cest močových
aktualizace 2011


Authors: M. Roupręt 1;  R. Zigeuner 2;  J. Palou 3;  A. Boehle 4;  E. Kaasinen 5;  R. Sylvester 6;  M. Babjuk 7;  W. Oosterlinck 8
Authors‘ workplace: Second Faculty of Medicine, Charles University, Praha, Czech Republic ;  Faculty of Medicine Pierre et Marie Curie, University Paris VI, Paris, France ;  Department of Urology, Pitié-Salpétričre Hospital, GHU Est, Assistance-Publique Hôpitaux de Paris 1;  Department of Urology, Medical University of Graz, Graz, Austria 2;  Department of Urology, Fundació Puigvert, Barcelona, Spain 3;  Department of Urology, HELIOS Agnes Karll Hospital, 23 11 Bad Schwartau, Germany 4;  Department of Urology, Hyvinkää Hospital, Hysinkää, Finland 5;  European Organisation for Research and Treatment of Cancer Headquarters, Department of Biostatistics, 1200 Brussels, Belgium 6;  Department of Urology, Hospital Motol 7;  Department of Urology, University Hospital Ghent, De Pintelaan 185, 9000 Ghent, Belgium, morgan. roupret@psl. aphp. fr 8
Published in: Urol List 2011; 9(4): 59-70
Category: Guidelines

Overview

Context:
The European Association of Urology (EAU) Guideline Group for urothelial cell carcinoma of the upper urinary tract (UUT-UCC) has prepared new guidelines to aid clinicians in assessing the current evidence-based management of UUT-UCC and to incorporate present recommendations into daily clinical practice.

Objective:
This paper provides a brief overviewof the EAU guidelines on UUT-UCC as an aid to clinicians in their daily practice.

Evidence acquisition:
The recommendations provided in the current guidelines are basedon a thorough reviewof available UUT-UCC guidelines and papers identified using a systematic search of Medline. Data on urothelial malignancies and UUT-UCC in the literature were searched using Medline with the following keywords: urinary tract cancer, urothelial carcinomas, upper urinary tract, carcinoma, transitional cell, renal pelvis, ureter, bladder cancer, chemotherapy, nephroureterectomy, adjuvant treatment, neoadjuvant treatment, recurrence, risk factors, and survival. A panel of experts weighted the references.

Evidence synthesis:
There is a lack of data in the current literature to provide strong re­com­mendations due to the rarity of the disease. A number of recent multicentre studies are now available, whereas earlier publications were based only on limited populations. However, most of these studies have been retrospective analyses. The TNM classification 2009 is recommended. Recommendations are given for diagnosis as well as for radical and conservative treatment; prognostic factors are also discussed. Recommendations are provided for patient follow-up after different therapeutic options.

Conclusions:
These guidelines contain information for the diagnosis and treatment of individual patients according to a current standardised approach. When determining the optimal treatment regimen, physicians must take into account each individual patient’s specific clinical characteristics with regard to renal function inclu­ding medical comorbidities; tumour location, grade and stage; and molecular marker status.


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