Quality indicators for the management of high-risk upper tract urothelial carcinoma requiring radical nephroureterectomy

Frederik König; Shahrokh F Shariat; Pierre I Karakiewicz; Dong-Ho Mun; Michael Rink; Benjamin Pradere

doi:10.1097/MOU.0000000000000895

Quality indicators for the management of high-risk upper tract urothelial carcinoma requiring radical nephroureterectomy

Standard

Quality indicators for the management of high-risk upper tract urothelial carcinoma requiring radical nephroureterectomy. / König, Frederik; Shariat, Shahrokh F; Karakiewicz, Pierre I; Mun, Dong-Ho; Rink, Michael; Pradere, Benjamin.

In: CURR OPIN UROL, Vol. 31, No. 4, 01.07.2021, p. 291-296.

Research output: SCORING: Contribution to journal › SCORING: Review article › Research

Harvard

König, F, Shariat, SF, Karakiewicz, PI, Mun, D-H, Rink, M & Pradere, B 2021, 'Quality indicators for the management of high-risk upper tract urothelial carcinoma requiring radical nephroureterectomy', CURR OPIN UROL, vol. 31, no. 4, pp. 291-296. https://doi.org/10.1097/MOU.0000000000000895

APA

König, F., Shariat, S. F., Karakiewicz, P. I., Mun, D-H., Rink, M., & Pradere, B. (2021). Quality indicators for the management of high-risk upper tract urothelial carcinoma requiring radical nephroureterectomy. CURR OPIN UROL, 31(4), 291-296. https://doi.org/10.1097/MOU.0000000000000895

Vancouver

König F, Shariat SF, Karakiewicz PI, Mun D-H, Rink M, Pradere B. Quality indicators for the management of high-risk upper tract urothelial carcinoma requiring radical nephroureterectomy. CURR OPIN UROL. 2021 Jul 1;31(4):291-296. https://doi.org/10.1097/MOU.0000000000000895

Bibtex

@article{934b70ed8696427faf9f0f1a4081c39a,

title = "Quality indicators for the management of high-risk upper tract urothelial carcinoma requiring radical nephroureterectomy",

abstract = "PURPOSE OF REVIEW: The purpose of this article was to identify quality indicators for an optimized management of high-risk upper tract urothelial carcinoma (UTUC) requiring radical nephroureterectomy (RNU).RECENT FINDINGS: RNU with bladder cuff resection is the standard treatment of high-risk UTUC. For the bladder cuff resection, two main approaches are accepted: transvesical and extravesical. Lymph node dissection following a dedicated template should be performed in all high-risk patients undergoing RNU as it improves tumour staging and possibly survival. Postoperative bladder instillation of single-dose chemotherapy should be administered after RNU to decrease the risk of intravesical tumour recurrence. Perioperative systemic chemotherapy should always be considered for advanced cancers. Although level-1 evidence is available for adjuvant platinum-based chemotherapy, neoadjuvant regimens are still being evaluated.SUMMARY: Optimal management of high-risk UTUC requires evidence-based reproducible quality indicators in order to allow guidance and frameworks for clinical practices. Adherence to quality indicators allows for the measurement and comparison of outcomes that are likely to improve prognosis. Based on the literature, we found four evidence-based accepted quality indicators that are easily implementable to improve the management of high-risk UTUC patients treated with RNU: adequate management of the distal ureter/ bladder cuff, template-based lymph node dissection, single-shot postoperative intravesical chemotherapy, and perioperative systemic treatment.",

keywords = "Carcinoma, Transitional Cell/surgery, Humans, Kidney Neoplasms/surgery, Neoplasm Recurrence, Local/epidemiology, Nephroureterectomy, Quality Indicators, Health Care, Retrospective Studies, Ureter/surgery, Ureteral Neoplasms/surgery",

author = "Frederik K{\"o}nig and Shariat, {Shahrokh F} and Karakiewicz, {Pierre I} and Dong-Ho Mun and Michael Rink and Benjamin Pradere",

year = "2021",

month = jul,

day = "1",

doi = "10.1097/MOU.0000000000000895",

language = "English",

volume = "31",

pages = "291--296",

journal = "CURR OPIN UROL",

issn = "0963-0643",

publisher = "Lippincott Williams and Wilkins",

number = "4",

}

RIS

TY - JOUR

T1 - Quality indicators for the management of high-risk upper tract urothelial carcinoma requiring radical nephroureterectomy

AU - König, Frederik

AU - Shariat, Shahrokh F

AU - Karakiewicz, Pierre I

AU - Mun, Dong-Ho

AU - Rink, Michael

AU - Pradere, Benjamin

PY - 2021/7/1

Y1 - 2021/7/1

N2 - PURPOSE OF REVIEW: The purpose of this article was to identify quality indicators for an optimized management of high-risk upper tract urothelial carcinoma (UTUC) requiring radical nephroureterectomy (RNU).RECENT FINDINGS: RNU with bladder cuff resection is the standard treatment of high-risk UTUC. For the bladder cuff resection, two main approaches are accepted: transvesical and extravesical. Lymph node dissection following a dedicated template should be performed in all high-risk patients undergoing RNU as it improves tumour staging and possibly survival. Postoperative bladder instillation of single-dose chemotherapy should be administered after RNU to decrease the risk of intravesical tumour recurrence. Perioperative systemic chemotherapy should always be considered for advanced cancers. Although level-1 evidence is available for adjuvant platinum-based chemotherapy, neoadjuvant regimens are still being evaluated.SUMMARY: Optimal management of high-risk UTUC requires evidence-based reproducible quality indicators in order to allow guidance and frameworks for clinical practices. Adherence to quality indicators allows for the measurement and comparison of outcomes that are likely to improve prognosis. Based on the literature, we found four evidence-based accepted quality indicators that are easily implementable to improve the management of high-risk UTUC patients treated with RNU: adequate management of the distal ureter/ bladder cuff, template-based lymph node dissection, single-shot postoperative intravesical chemotherapy, and perioperative systemic treatment.

AB - PURPOSE OF REVIEW: The purpose of this article was to identify quality indicators for an optimized management of high-risk upper tract urothelial carcinoma (UTUC) requiring radical nephroureterectomy (RNU).RECENT FINDINGS: RNU with bladder cuff resection is the standard treatment of high-risk UTUC. For the bladder cuff resection, two main approaches are accepted: transvesical and extravesical. Lymph node dissection following a dedicated template should be performed in all high-risk patients undergoing RNU as it improves tumour staging and possibly survival. Postoperative bladder instillation of single-dose chemotherapy should be administered after RNU to decrease the risk of intravesical tumour recurrence. Perioperative systemic chemotherapy should always be considered for advanced cancers. Although level-1 evidence is available for adjuvant platinum-based chemotherapy, neoadjuvant regimens are still being evaluated.SUMMARY: Optimal management of high-risk UTUC requires evidence-based reproducible quality indicators in order to allow guidance and frameworks for clinical practices. Adherence to quality indicators allows for the measurement and comparison of outcomes that are likely to improve prognosis. Based on the literature, we found four evidence-based accepted quality indicators that are easily implementable to improve the management of high-risk UTUC patients treated with RNU: adequate management of the distal ureter/ bladder cuff, template-based lymph node dissection, single-shot postoperative intravesical chemotherapy, and perioperative systemic treatment.

KW - Carcinoma, Transitional Cell/surgery

KW - Humans

KW - Kidney Neoplasms/surgery

KW - Neoplasm Recurrence, Local/epidemiology

KW - Nephroureterectomy

KW - Quality Indicators, Health Care

KW - Retrospective Studies

KW - Ureter/surgery

KW - Ureteral Neoplasms/surgery

U2 - 10.1097/MOU.0000000000000895

DO - 10.1097/MOU.0000000000000895

M3 - SCORING: Review article

C2 - 33973537

VL - 31

SP - 291

EP - 296

JO - CURR OPIN UROL

JF - CURR OPIN UROL

SN - 0963-0643

IS - 4

ER -