Strategies of Endoscopic Management of Upper Tract Urothelial Carcinoma among Endourologists: A Global Survey

Up-to-date guidelines on the management of upper tract urothelial carcinoma (UTUC) are continuously published. We aim to assess the variability of diagnosis and treatment strategies in the endoscopic management of UTUC and adherence to European Association of Urology and National Comprehensive Cancer Network guidelines. A 15-question survey was designed to query practitioners on approaches to clinical practice and knowledge about endoscopic treatment indications and techniques. It was emailed to all members of the Endourologic Society through the society's office, and to all Israeli non-member endourologists. Eighty-eight urologists participated in the survey. Adherence to guidelines on indications for endoscopic management was only 51%. Most of the survey respondents (87.5%) use holmium laser for tumor ablation, and similar to 50% use forceps for biopsy while the other half use baskets. Only 50% stated that they would use Jelmyto((R)) for specific indications. Most (80%) indicated that they repeat the ureteroscopy 3 months after the first one, and 52.3% continue with follow-up ureteroscopy every 3 months during the first year after diagnosis. There is vast variability among endourologists in the technical aspects of UTUC, the indications for endoscopic management, and adherence to the available guidelines for managing UTUC.

Automated summary

This study aimed to evaluate the variability in diagnosis and treatment strategies for upper tract urothelial carcinoma (UTUC) and adherence to guidelines among endourologists. A survey was conducted with 88 urologists, revealing that only 51% adhered to guidelines for endoscopic management indications. The majority used holmium laser for tumor ablation and had varying preferences for biopsy methods. There was significant variability in the technical aspects of UTUC, treatment indications, and adherence to guidelines.