title: [Surgical treatment of upper tract urothelial carcinomas by nephroureterectomy: state of the art review for the yearly scientific report of the French National Association of Urology].
abstract: OBJECTIVE
  To review current knowledge about techniques of radical nephroureterectomy (RNU) for the treatment of the upper urinary tract cancer (UTUC).
  
  
  METHODS
  A systematic review of the literature search was performed from the database Medline (NLM, Pubmed), focused on the following key-words; nephroureterectomy; renal pelvis; ureter; bladder-cuff excision; urothelial carcinoma; surgery; lymph-node dissection; laparoscopy.
  
  
  RESULTS
  The removal of a bladder-cuff during RNU is mandatory. After the surgical procedure, intravesical instillation of ametycine reduces significantly the risk of recurrence into the bladder. Ureteral stripping should not be practiced and continuity of the bladder wall must be restored to avoid compromising the post-operative instillation. Lymphadenectomy during RNU is of prognostic and therapeutic interests. However, the anatomic sites of lymphadenectomy and the number of nodes to be analyzed are not consensual. The oncological results of laparoscopic approach are similar to those of open surgery.
  
  
  CONCLUSIONS
  The RNU must include a lymphadenectomy and an excision of a bladder-cuff and restore the sealing of the bladder to allow practicing of a EPOI. Laparoscopic or open surgery may be used equally, and must respect these rules to avoid compromising the oncological outcome.
authors.affiliation: Service d'urologie et de transplantation rénale, université de Versailles-Saint-Quentin-en-Yvelines, hôpital Foch, 92150 Suresnes, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Neuzillet
authors.affiliation: Service d'urologie, hôpital de Seclin, rue d'Apolda, 59113 Seclin, France; Service d'urologie, générale de santé, hôpital privé de la Louvière, 69, rue de la Louvière, 59000 Lille, France.
authors.forename: P
authors.initials: P
authors.lastname: Colin
authors.affiliation: Service d'urologie, faculté de médecine Pierre-et-Marie-Curie, université Paris 6, UPMC université Paris 6, GRC n(o) 5, oncotype-URO, hôpital Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, 83, boulevard Hôpital, 75013 Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Phé
authors.affiliation: Department of urology, Medical University of Vienna, Vienna, Autriche.
authors.forename: S F
authors.initials: SF
authors.lastname: Shariat
authors.affiliation: Service d'urologie, faculté de médecine Pierre-et-Marie-Curie, université Paris 6, UPMC université Paris 6, GRC n(o) 5, oncotype-URO, hôpital Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, 83, boulevard Hôpital, 75013 Paris, France. Electronic address: morgan.roupret@psl.aphp.fr.
authors.forename: M
authors.initials: M
authors.lastname: Rouprêt
mesh_terms: D002295:Carcinoma, Transitional Cell / Q000473:pathology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D009392:Nephrectomy; D014513:Ureter / Q000601:surgery*; D018666:Ureteroscopy; D014571:Urologic Neoplasms / Q000473:pathology / Q000601:surgery*; D019459:Urothelium / Q000473:pathology*
keywords: Bassinet; Bladder-cuff excision; Carcinome urothélial; Chirurgie; Collerette vésicale; Curage ganglionnaire; Laparoscopie; Laparoscopy; Lymph-node dissection; Nephroureterectomy; Néphro-urétérectomie; Renal pelvis; Surgery; Ureter; Uretère; Urothelial carcinoma