Diagnosis and Management of Non-Metastatic Upper Tract Urothelial Carcinoma: AUA/SUO Guideline

J Urol. 2023 Jun;209(6):1071-1081. doi: 10.1097/JU.0000000000003480. Epub 2023 Apr 25.


Purpose: The purpose of this guideline is to provide a useful reference on the effective evidence-based diagnoses and management of non-metastatic upper tract urothelial carcinoma (UTUC).

Materials/methods: The Pacific Northwest Evidence-based Practice Center of Oregon Health & Science University (OHSU) team conducted searches in Ovid MEDLINE (1946 to March 3rd, 2022), Cochrane Central Register of Controlled Trials (through January 2022), and Cochrane Database of Systematic Reviews (through January 2022). The searches were updated August 2022. When sufficient evidence existed, the body of evidence was assigned a strength rating of A (high), B (moderate), or C (low) for support of Strong, Moderate, or Conditional Recommendations. In the absence of sufficient evidence, additional information is provided as Clinical Principles and Expert Opinions (Table 1).[Table: see text]Results:This Guideline provides updated, evidence-based recommendations regarding diagnosis and management of non-metastatic UTUC including risk stratification, surveillance and survivorship. Treatments discussed include kidney sparing management, surgical management, lymph node dissection (LND), neoadjuvant/adjuvant chemotherapy and immunotherapy.

Conclusion: This standardized guideline seeks to improve clinicians' ability to evaluate and treat patients with UTUC based on available evidence. Future studies will be essential to further support these statements for improving patient care. Updates will occur as the knowledge regarding disease biology, clinical behavior and new therapeutic options develop.

Keywords: UTUC; renal pelvis cancer; upper tract urothelial cancer; ureteral cancer; urothelial cancer.

MeSH terms

  • Carcinoma, Transitional Cell* / diagnosis
  • Carcinoma, Transitional Cell* / therapy
  • Humans
  • Kidney
  • Oregon
  • Systematic Reviews as Topic
  • Ureteral Neoplasms* / diagnosis
  • Ureteral Neoplasms* / therapy
  • Urinary Bladder Neoplasms*