Current practice patterns in urologic management of upper-tract transitional-cell carcinoma

Area of Science:

• Urology
• Oncology

Background:

• Upper-tract transitional-cell carcinoma (TCC) is a rare malignancy.
• Management strategies require careful consideration of tumor grade, stage, and location.

Purpose of the Study:

• To survey current practice patterns in the management of upper-tract TCC among urologists.
• To identify trends in diagnosis, surveillance, and treatment of upper-tract TCC.

Main Methods:

• A survey was distributed to 220 urologists from the Society of Urologic Oncology (SUO), Endourological Society (ES), and American Urological Association.
• Seventy responses were analyzed to determine practice trends in upper-tract TCC management.

Main Results:

• CT urogram (53%) and IV urogram (40%) were favored for initial diagnosis.
• Ureterorenoscopy (70%) was the preferred surveillance tool post-conservative treatment.
• Laparoscopic nephroureterectomy (73%) was preferred for high-grade, large renal-pelvic TCC, contrasting with ureteroscopic ablation (21%) vs. distal ureterectomy (77%) for distal ureteral tumors.

Conclusions:

• Urologist practices for upper-tract TCC generally align with published literature.
• Minimally invasive techniques are favored for upper-tract TCC management, irrespective of practice setting or experience.
• Findings may inform the development of clinical guidelines for upper-tract TCC.