title: Current position of diagnostics and surgical treatment for upper tract urothelial carcinoma.
abstract: BACKGROUND
  The applicability of urinary biomarkers and optical diagnostics in upper urinary tract carcinoma (UUT-UC) are increasingly debated. To receive insight in the opinion of the urological community involved in this field, a survey was sent out to identify the most promising techniques and understand the need for new diagnostics. Primary objective of this study was to provide an overview of current diagnostics in upper urinary tract urothelial carcinoma. Secondary objectives of this study was to assess the need for additional diagnostic techniques in the current diagnostic work-up for UUT-UC and to assess knowledge of novel techniques.
  
  
  METHODS
  An electronic survey was distributed to all participants of the upper urinary tract tumor registration study by the Clinical Research Office of the Endourological Society. Additionally, based on publications, experts in the field were contacted. Analysis was performed on the results overviewed by the survey monkey website.
  
  
  RESULTS
  In total 81 of the 112 invited individuals responded resulting in a response rate of 72.3%. Most urologists involved in the treatment of upper urinary tract tumors follow the guidelines in their diagnostic work-up of patients suspected for UUT-UC. 61.4% of all responders consider current available diagnostic methods insufficient to select patient candidates for conservative renal sparing surgery. According to the responders, digital endoscopes for retrograde intrarenal surgery (RIRS) including narrow-band imaging (NBI) are best known and most likely to be beneficial compared to all evaluated diagnostic tools currently available.
  
  
  CONCLUSIONS
  Urologists consider current diagnostic techniques for upper urinary tract tumors insufficient for optimal patient selection for conservative renal sparing surgery. Among the new techniques, NBI and digital RIRS are best known and considered to be beneficial in the diagnostic work-up.
authors: Department of Urology, Academic Medical Center, Amsterdam, The Netherlands - m.t.bus@amc.uva.nl.
authors: Mieke T
authors: MT
authors: Bus
authors: Department of Urology, Academic Medical Center, Amsterdam, The Netherlands.|Department of Biomedical Engineering and Physics, Academic Medical Center, Amsterdam, The Netherlands.
authors: Daniel M
authors: DM
authors: de Bruin
authors: Department of Urology, Academic Medical Center, Amsterdam, The Netherlands.
authors: Guido M
authors: GM
authors: Kamphuis
authors: Department of Urology, Academic Medical Center, Amsterdam, The Netherlands.
authors: Patricia J
authors: PJ
authors: Zondervan
authors: Department of Urology, Academic Medical Center, Amsterdam, The Netherlands.
authors: M Pilar
authors: MP
authors: Laguna Pes
authors: Department of Urology, Academic Medical Center, Amsterdam, The Netherlands.
authors: Theo M
authors: TM
authors: de Reijke
authors: Department of Biomedical Engineering and Physics, Academic Medical Center, Amsterdam, The Netherlands.
authors: Ton G
authors: TG
authors: van Leeuwen
authors: Department of Urology, Academic Medical Center, Amsterdam, The Netherlands.
authors: Jean J
authors: JJ
authors: de la Rosette
mesh_terms: D019983:Guideline Adherence; D006801:Humans; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D014571:Urologic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods / Q000592:standards