Key changes for the 2018 print:
- Figure 6.2 - Risk stratification of upper urinary tract urothelial carcinoma, tumour size cut off for high-risk UTUC has been changed to > 2 cm;
- Section 6.6 - Summary of evidence and guidelines for prognosis – recommendation ‘Use the America Society of Anesthesiologists score to assess cancer-specific survival’ – was taken out;
- Section 7.1.4.3 - Summary of evidence and recommendations for radical nephroureterectomy.
| Recommendations | Strength rating |
| Perform radical nephroureterectomy in patients with high-risk tumours. | Strong |
| Technical steps of radical nephroureterectomy: | |
Offer a post-operative bladder instillation of chemotherapy to lower the intravesical recurrence rate. | Strong
|
- Section 8.1: Summary of evidence and follow-up of UTUC
| Recommendations | Strength rating |
| After radical nephroureterectomy: | |
| Low-risk tumours | |
| Perform cystoscopy at three months. If negative, perform subsequent cystoscopy nine months later and then yearly, for five years. | Weak
|
| Perform computed tomography urography every year for five years. | Weak |
| High-risk tumours | |
| Perform cystoscopy and urinary cytology at three months. If negative, repeat subsequent cystoscopy and cytology every three months for a period of two years, and every six months thereafter until five years, and then yearly. | Weak
|
| Perform computed tomography urography every six months for two years, and then yearly. | Weak
|
| After kidney-sparing management: | |
| Low-risk tumours | |
| Perform cystoscopy and computed tomography urography at three and six months, and then yearly for five years. | Weak
|
| Perform ureteroscopy at three months. | Weak |
| High-risk tumours | |
| Perform cystoscopy, urinary cytology and computed tomography urography at three and six months, and then yearly. | Weak
|
| Perform ureteroscopy and urinary cytology in situ at three and six months. | Weak |