Urothelial carcinoma (UC) affecting the urinary tract is recognized as one of the prevalent types of cancer, ranking fifth in terms of incidence. However, it is important to note that upper tract UC (UTUC), in comparison to bladder cancer (BC), is relatively uncommon and represents a minority of UC cases, accounting for approximately 5-10%.
It is worth emphasizing that up to 60% of UTUC cases are invasive at the time of diagnosis, in contrast to 25% of BC cases. These statistics highlight the urgent need for well-designed, multi-disciplinary strategies to guide optimal management for this vulnerable patient population, aiming to control treatment variability and minimize the risks associated with under- and over-treatment.
In this study, we present a comparative analysis of the contemporary guidelines on UTUC management from the European Association of Urology (EAU) and the American Urological Association/Society of Urologic Oncology (AUA/SUO) released in 2023. Our objective is to contrast the different guidelines and examine the evidence on which their recommendations are based.
By thoroughly reviewing the guidelines from both organizations, we observed substantial agreement on the management of UTUC. However, we also identified noticeable differences among these guidelines, leading to a wide range of recommendations. These disparities might stem from variations in clinical practices, regional preferences, and the availability of resources. It is crucial to acknowledge that both the EAU and AUA/SUO base their guidelines on the latest scientific evidence and expert consensus within their respective regions.
These findings underscore the importance of ongoing collaboration, knowledge exchange, and harmonization of guidelines to improve the standard of care for UTUC globally. Future research should focus on identifying areas of consensus and bridging the gaps between different international guidelines to enhance the management outcomes for this challenging disease.
Journal of endourology. 2024 Mar 01 [Epub ahead of print]
Catalina Solano, Mariela Corrales, Etienne Xavier Keller, Jia-Lun Kwok, Frédéric Panthier, Steeve Doizi, Olivier Traxer
GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France, Urology, Tenon Hospital, 4 rue de la Chine,, Paris, France, 75020., Hospital Tenon, 55705, Urology, 4 Rue de la Chine, Paris, Île-de-France, France, 75020; ., University Hospital Zürich, Department of Urology, Frauenklinikstrasse 10, Zurich, Switzerland, 8091; ., University Hospital Zurich, 27243, Department of Urology, Zurich, Zürich, Switzerland; ., Hopital Tenon, 55705, GRC n20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, Paris, Île-de-France, France; ., Tenon Hospital, Assistance-Publique Hôpitaux de Paris, Urology, 4 rue de la Chine, Paris, France, 75020; ., Hospital Tenon, 55705, Urology, 4 rue de la Chine, Paris, France, 75970; .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/38429915