Contemporary patterns of presentation, diagnostics and management of upper tract urothelial cancer in 101 centres: the Clinical Research Office of the Endourological Society Global upper tract urothelial carcinoma registry

Curr Opin Urol. 2021 Jul 1;31(4):354-362. doi: 10.1097/MOU.0000000000000899.

Abstract

Purpose of review: To assess patterns of presentation, diagnostics and treatment in patients with upper tract urothelial carcinoma (UTUC), a multicentre registry was launched. Clinical data of UTUC patients were prospectively collected over a 5-year period.

Recent findings: Data from 2380 patients were included from 2014 to 2019 (101 centres in 29 countries). Patients were predominantly male (70.5%) and 53.3% were past or present smokers. The majority of patients (58.1%) were evaluated because of symptoms, mainly macroscopic hematuria. Computed tomography (CT) was the most common performed imaging modality (90.5%). A ureteroscopy (URS) was part of the diagnostic process in 1184 (49.7%) patients and 488 (20.5%) patients were treated endoscopically. In total, 1430 patients (60.1%) were treated by a radical nephroureterectomy, 59% without a prior diagnostic URS. Eighty-two patients (3.4%) underwent a segmental resection, 19 patients (0.8%) were treated by a percutaneous tumour resection.

Summary: Our data is in line with the known epidemiologic characteristics of UTUC. CT imaging is the preferred imaging modality as also recommended by guidelines. Diagnostic URS gained a stronger position, however, in almost half of patients a definitive treatment decision was made without complete endoscopic information. Only one-third of patients with UTUC are currently treated with kidney sparing surgery.

Trial registration: ClinicalTrials.gov NCT02281188.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Carcinoma, Transitional Cell* / diagnostic imaging
  • Carcinoma, Transitional Cell* / epidemiology
  • Female
  • Humans
  • Kidney Neoplasms* / surgery
  • Male
  • Nephroureterectomy
  • Registries
  • Ureteral Neoplasms* / diagnostic imaging
  • Ureteral Neoplasms* / epidemiology
  • Ureteroscopy

Associated data

  • ClinicalTrials.gov/NCT02281188