Recommandations en onco-urologie 2013 du CCAFU : Tumeurs de la voie excrétrice urinaire supérieure

INTRODUCTION The objective was to update the guidelines of the French Urological Association Cancer Committee for upper tract urothelial carcinoma (UTUC). METHODS A Medline search was performed between 2010 and 2013, as regards diagnosis, options of treatment and follow-up of UTUC, to evaluate different references with levels of evidence. RESULTS The diagnosis of this rare pathology is based on CT-scan acquisition during excretion and ureteroscopy with histological biopsies. Total nephro-urectomy remains the gold standard for surgical treatment, nevertheless a conservative endoscopic approach can be proposed : unifocal tumour and diameter < 1 cm and low grade and absence of invasion on CT-scan. Close monitoring with endoscopic follow-up (flexible ureteroscope) in compliant patients is therefore necessary. CONCLUSION These new guidelines will hopefully contribute not only to improve patient management, but also diagnosis and treatment for UTUC.