title: [Conservative management of urothelial carcinomas of the upper tract: systematic review for the yearly scientific report of the French National Association of Urology].
abstract: OBJECTIVE
  To assess techniques, indications and results of conservative surgical management in upper tract urothelial carcinomas (UTUCs).
  
  
  METHODS
  A systematic review of the scientific literature was performed in the Medline database (PubMed) using different associations of the following key words alone or in combination: ureter; renal pelvis; urothelial carcinoma; cancer; survival; renal insufficiency; ureteroscopy; kidney; grade; stage; surveillance.
  
  
  RESULTS
  Conservative management is indicated in imperative cases (solitary kidney) or in elective cases to preserve renal function as much as possible. When a patient has two kidneys, indications of conservative treatment are dedicated to UTUC with the following characteristics: less than 1cm, low grade, unique contingent upon the fact that the patient has understood that stringent follow-up was mandatory. Current technique of reference is flexible ureteroscopy but open segmental ureterectomy is still indicated in isolated tumor of distal ureter. Oncologic outcomes after conservative management are equivalent to those obtained after nephroureterectomy in low grade/volume UTUCs.
  
  
  CONCLUSIONS
  Indications of conservative management in UTUCs have been expanded in the past years in relationship with the development of new and sophisticated endourological ureteroscopes to obtain good oncologic outcomes contingent upon a stringent follow-up and even a systematic second look procedure in certain cases.
authors.affiliation: Service d'urologie, hôpital Bicêtre, AP-HP, université Paris Sud, 94270 Kremlin-Bicêtre, France.
authors.forename: G
authors.initials: G
authors.lastname: Pignot
authors.affiliation: Service d'urologie, hôpital privé de la Louvière, générale de santé, 69, rue de la Louvière, 59000 Lille, France; Service d'urologie, hôpital de Seclin, rue d'Apolda, 59113 Seclin, France.
authors.forename: P
authors.initials: P
authors.lastname: Colin
authors.affiliation: Service d'urologie, hôpital Pitié-Salpêtrière, AP-HP, faculté de médecine Pierre-et-Marie-Curie, université Paris 6, GRC n(o) 5, ONCOTYPE-URO, 83, boulevard Hôpital, 75013 Paris, France. Electronic address: morgan.roupret@psl.aphp.fr.
authors.forename: M
authors.initials: M
authors.lastname: Rouprêt
authors.affiliation: Service d'urologie, hôpital Tenon, AP-HP, faculté de médecine Pierre-et-Marie-Curie, université Paris 6, 75020 Paris, France.
authors.forename: O
authors.initials: O
authors.lastname: Traxer
mesh_terms: D002295:Carcinoma, Transitional Cell / Q000473:pathology / Q000601:surgery*; D004724:Endoscopy; D006801:Humans; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D014571:Urologic Neoplasms / Q000473:pathology / Q000601:surgery*; D013520:Urologic Surgical Procedures; D019459:Urothelium / Q000473:pathology*
keywords: Bassinet; Cancer; Carcinome urothélial; Grade; Insuffisance rénale; Kidney; Rein; Renal insufficiency; Renal pelvis; Stade; Stage; Surveillance; Survie; Survival; Ureter; Ureteroscopy; Uretère; Urothelial carcinoma; Urétéroscopie