Patients who underwent radical nephroureterectomy with distal ureter management for UTUC between January 1990 and June 2010 at 10 Canadian tertiary hospitals were retrospectively analyzed in a pooled database.
Staging was performed according to the 2002 American Joint Committee on Cancer Tumor Node and Metastases staging system for UTUC.
The European Association of Urology UTUC guidelines suggest that location of UTUC and multifocality serve as predictors of poor prognosis.
The European Association of Urology (EAU) and the National Comprehensive Cancer Network (NCCN) have developed guidelines for the diagnosis and treatment of UTUC.
We hypothesize that there is considerable variability in the management of UTUC primarily by nephroureterectomy across Canada and that this has a direct effect on patient outcome.
In this study, we analyzed practice patterns across Canada with respect to the management of UTUC and correlated these to clinical outcomes.
10] The difference with UTUC is that tumours are more likely low grade and more often non-muscle invasive, whereas in the bladder, tumours are almost all high grade, and many are muscle invasive.
The high variability in management of UTUC in Canada underlines the urgent need for more multi-institutional controlled trials which may aid in the development of specific best practice guidelines.
There is significant variability in practice patterns for UTUC across Canada.
Lymph node involvement has a negative effect on survival in UTUC, although no differences were found between those with node-negative status and those in whom lymphadenectomy was not performed.
Let's not hold our breath, and instead congratulate UTUC collaborations, such as CUTC and UTUCC, for their efforts in uncovering realities and opportunities in this challenging oncologic space.