title: European Association of Urology Guidelines on Upper Urinary Tract Urothelial Cell Carcinoma: 2015 Update.
abstract: BACKGROUND
  The European Association of Urology (EAU) guidelines panel on upper urinary tract urothelial cell carcinoma (UTUC) has prepared updated guidelines to aid clinicians in the current evidence-based management of UTUC and to incorporate recommendations into clinical practice.
  
  
  OBJECTIVE
  To provide a brief overview of the EAU guidelines on UTUC as an aid to clinicians.
  
  
  METHODS
  The recommendations provided in the current guidelines are based on a thorough review of available UTUC guidelines and articles identified following a systematic search of Medline. Data on urothelial malignancies and UTUC were searched using these keywords: urinary tract cancer; urothelial carcinomas; upper urinary tract, carcinoma; renal pelvis; ureter; bladder cancer; chemotherapy; nephroureterectomy; adjuvant treatment; instillation; neoadjuvant treatment; recurrence; risk factors; and survival. References were weighted by a panel of experts.
  
  
  RESULTS
  Due to the rarity of UTUC, there are insufficient data to provide strong recommendations (ie, grade A). However, the results of recent multicentre studies are now available, and there is a growing interest in UTUC. The 2009 TNM classification is recommended. Recommendations are given for diagnosis and risk stratification as well as radical and conservative treatment, and prognostic factors are discussed. A single postoperative dose of intravesical mitomycin after nephroureterectomy reduces the risk of bladder tumour recurrence. Recommendations are also provided for patient follow-up after different therapeutic strategies.
  
  
  CONCLUSIONS
  These guidelines contain information on the management of individual patients according to a current standardised approach. Urologists should take into account the specific clinical characteristics of each patient when determining the optimal treatment regimen, based on the proposed risk stratification of these tumours.
  
  
  RESULTS
  Urothelial carcinoma of the upper urinary tract is rare, but because 60% of these tumours are invasive at diagnosis, an appropriate diagnosis is most important. A number of known risk factors exist.
authors.affiliation: Department of Urology, Hospital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, University Pierre et Marie Curie, Institut Universitaire de Cancérologie, Paris, France. Electronic address: morgan.roupret@aphp.fr.
authors.forename: Morgan
authors.initials: M
authors.lastname: Rouprêt
authors.affiliation: Department of Urology, Hospital Motol and 2nd Faculty of Medicine, Charles University, Prague, Czech Republic.
authors.forename: Marko
authors.initials: M
authors.lastname: Babjuk
authors.affiliation: Department of Pathology, Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, University Pierre et Marie Curie, Institut Universitaire de Cancérologie, Paris, France.
authors.forename: Eva
authors.initials: E
authors.lastname: Compérat
authors.affiliation: Department of Urology, Medizinische Universität Graz, Graz, Austria.
authors.forename: Richard
authors.initials: R
authors.lastname: Zigeuner
authors.affiliation: EAU Guidelines Office Board, European Association of Urology, The Netherlands.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Sylvester
authors.affiliation: Department of Urology, Caritas St. Josef Medical Centre, University of Regensburg, Regensburg, Germany.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Burger
authors.affiliation: Department of Radiology, Queen Alexandra Hospital, Portsmouth, UK.
authors.forename: Nigel C
authors.initials: NC
authors.lastname: Cowan
authors.affiliation: Helios Agnes Karll Krankenhaus, Schwartau, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Böhle
authors.affiliation: Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Bas W G
authors.initials: BW
authors.lastname: Van Rhijn
authors.affiliation: Department of Surgery, Hyvinkää Hospital, Hyvinkää, Finland.
authors.forename: Eero
authors.initials: E
authors.lastname: Kaasinen
authors.affiliation: Department of Urology, Universitat Autònoma de Barcelona-Fundació Puigvert, Barcelona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Palou
authors.affiliation: Department of Urology, Comprehensive Cancer Centre, Medical University of Vienna, Vienna General Hospital, Vienna, Austria; Department of Urology, Weill Medical College of Cornell University, New York, NY, USA; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Shahrokh F
authors.initials: SF
authors.lastname: Shariat
mesh_terms: D000283:Administration, Intravesical; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000628:therapy*; D007682:Kidney Pelvis / Q000473:pathology; D016685:Mitomycin / Q000627:therapeutic use*; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D009392:Nephrectomy; D012955:Societies, Medical; D014513:Ureter / Q000601:surgery*; D014516:Ureteral Neoplasms / Q000175:diagnosis / Q000628:therapy*; D018666:Ureteroscopy; D001749:Urinary Bladder Neoplasms / Q000517:prevention & control*; D014572:Urology
chemical_list: D000903:Antibiotics, Antineoplastic; D016685:Mitomycin
keywords: Cytology; Guidelines; Nephroureterectomy; Renal pelvis; Risk factors; Survival; Ureter; Ureteroscopy; Urinary tract cancer; Urothelial carcinoma