Treatment of UTUC, Prognosis and Follow-Up

Radical nephroureterectomy (RNU) is the standard management of UTUC, because of the known high rate of recurrence of this disease. The main concern with radical nephrectomy is that it predisposes to chronic kidney disease, which is associated with cardiovascular events and increased mortality rates. The risk of contralateral tumours should also be considered. In a Chinese population-based study, older age, lower preoperative GFR, renal pelvic location of the tumour and multifocality were noted to be predictors of postoperative renal insufficiency [1]. Therefore, an organ-sparing approach may be beneficial in selected patients. During radical nephroureterectomy, care should be taken to prevent tumour seeding by avoiding entry into the urinary tract [2, 3]. The different surgical approaches are as follows.