Assessing EAU criteria for high‐risk upper tract urothelial carcinoma

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Main Authors: Mahmoud Farzat, Sami‐Ramzi Leyh‐Bannurah, Mykyta Kachanov, Florian M. Wagenlehner
Format: Artículo Open Access
Published: Wiley 2025
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author Mahmoud Farzat
Sami‐Ramzi Leyh‐Bannurah
Mykyta Kachanov
Florian M. Wagenlehner
author_facet Mahmoud Farzat
Sami‐Ramzi Leyh‐Bannurah
Mykyta Kachanov
Florian M. Wagenlehner
Mahmoud Farzat
Sami‐Ramzi Leyh‐Bannurah
Mykyta Kachanov
Florian M. Wagenlehner
collection Wiley Open Access
contents Assessing EAU criteria for high‐risk upper tract urothelial carcinoma Mahmoud Farzat Sami‐Ramzi Leyh‐Bannurah Mykyta Kachanov Florian M. Wagenlehner BJUI Compass Abstract Background and Objective Preoperative EAU guideline criteria stratify Upper tract urinary carcinomas (UTUC) into low‐ and high‐risk groups. Depending on this classification, high‐risk patients may receive simultaneous lymphadenectomy (LAD) during robot‐assisted radical nephroureterectomy (RANU). This study examines the reliability of such stratification, focusing on oncological outcomes. Methods In 60 patients with UTUC who underwent RANU, 38 were stratified as low‐risk (63%) and 22 as high‐risk (37%) based on preoperative EAU guideline criteria. LAD was performed solely in the high‐risk group. Results In the low‐risk group, 19 patients (50%) had non‐muscle‐invasive (Ta, Tis‐T1) disease, 7 (18%) had muscle‐invasive, locally confined (T2) disease and 12 (32%) had locally advanced (T3/4) disease. In the high‐risk group, results were 11 (50%), 3 (14%) and 8 (36%), with no statistical differences observed. Follow‐up (6 to 60 months) showed no significant differences in cancer‐specific (p = 0.3) and overall survival (p = 0.8) between groups. Limitations: the small sample size and the retrospective nature. Conclusions and Clinical Implications: The current EAU guideline‐based preoperative criteria for UTUC risk stratification demonstrated limited accuracy in identifying high‐risk patients undergoing RANU, potentially excluding some patients from receiving LAD. Patient Summary We think that improved preoperative staging and risk stratification tools are needed to better manage patients with upper urinary tract urothelial carcinoma undergoing surgical treatment. 10.1002/bco2.70044 http://creativecommons.org/licenses/by/4.0/
doi_str_mv 10.1002/bco2.70044
format Artículo Open Access
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institution Wiley Open Access
license_str_mv http://creativecommons.org/licenses/by/4.0/
publishDate 2025
publisher Wiley
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spellingShingle Assessing EAU criteria for high‐risk upper tract urothelial carcinoma
Mahmoud Farzat
Sami‐Ramzi Leyh‐Bannurah
Mykyta Kachanov
Florian M. Wagenlehner
BJUI Compass
Assessing EAU criteria for high‐risk upper tract urothelial carcinoma Mahmoud Farzat Sami‐Ramzi Leyh‐Bannurah Mykyta Kachanov Florian M. Wagenlehner BJUI Compass Abstract Background and Objective Preoperative EAU guideline criteria stratify Upper tract urinary carcinomas (UTUC) into low‐ and high‐risk groups. Depending on this classification, high‐risk patients may receive simultaneous lymphadenectomy (LAD) during robot‐assisted radical nephroureterectomy (RANU). This study examines the reliability of such stratification, focusing on oncological outcomes. Methods In 60 patients with UTUC who underwent RANU, 38 were stratified as low‐risk (63%) and 22 as high‐risk (37%) based on preoperative EAU guideline criteria. LAD was performed solely in the high‐risk group. Results In the low‐risk group, 19 patients (50%) had non‐muscle‐invasive (Ta, Tis‐T1) disease, 7 (18%) had muscle‐invasive, locally confined (T2) disease and 12 (32%) had locally advanced (T3/4) disease. In the high‐risk group, results were 11 (50%), 3 (14%) and 8 (36%), with no statistical differences observed. Follow‐up (6 to 60 months) showed no significant differences in cancer‐specific (p = 0.3) and overall survival (p = 0.8) between groups. Limitations: the small sample size and the retrospective nature. Conclusions and Clinical Implications: The current EAU guideline‐based preoperative criteria for UTUC risk stratification demonstrated limited accuracy in identifying high‐risk patients undergoing RANU, potentially excluding some patients from receiving LAD. Patient Summary We think that improved preoperative staging and risk stratification tools are needed to better manage patients with upper urinary tract urothelial carcinoma undergoing surgical treatment. 10.1002/bco2.70044 http://creativecommons.org/licenses/by/4.0/
title Assessing EAU criteria for high‐risk upper tract urothelial carcinoma
topic BJUI Compass
url https://bjui-journals.onlinelibrary.wiley.com/doi/10.1002/bco2.70044