EAU 2013 - Programme Book - YouMed

ESU Courses, 18 March
ESU Course 31
12.00 - 14.00 Current concepts and controversy in the diagnosis and management of
upper tract urothelial carcinoma (UTUC)
Green Hall 1 - Level N-1
Epidemiology, diagnosis, evaluation
M. Roupret, Paris (FR)
Prognostic and predictive factors, pathology
S.F. Shariat, New York (US)
Chair: S.F. Shariat, New York (US)
Treatment of low risk cancer (high grade Ta, T1 and CIS)
M. Roupret, Paris (FR)
Treatment of localized high risk (invasive) and metastatic cancer
S.F. Shariat, New York (US)
Aims and objectives
Upper tract urothelial carcinoma (UTUC) is an uncommon disease with little evidence-based data to
guide clinical decision-making. Recently, the tools available for the diagnosis and management of UTUC
have improved significantly, complementing a growing understanding of the biology of this disease. UTUC
requires appropriate management at all stages, since both the cure rate and morbidity are very sensitive
to nuances of treatment. Yet proper risk stratification remains a challenge owing to the difficulty of clinical
staging. This course will address contemporary concepts and controversies, including the timely and accurate
diagnosis of UTUC, emphasizing the integration of pathologic and radiographic variables for appropriate
risk stratification. Important features regarding the natural history of UTUC will also be emphasized; the
role of imaging and endoscopy in clinical decision making, diagnosis, staging and follow-up; and, common
pathways of metastatic spread. Up-to-date information regarding boundaries of surgical resection, indication
and extent of lymphadenectomy, clinical staging of UTUC, and the role of neoadjuvant chemotherapy in
patients with high risk UTUC will be detailed. Patient selection and treatment options for patients with UTUC
such as endoscopic management, distal ureterectomy, radical nephroureterectomy and chemotherapy will
be discussed.
Objectives: After attending this course, participants should be able to:
• identify problems associated with clinical staging of UTUC
• illustrate importance of accurate staging techniques and their role in clinical decision making maximize
ureteroscopic diagnostic biopsy and tumor resection
• be aware of newer modalities such as endoluminal ultrasound and other novel staging methods
• cite current concepts and controversies in the management of low-stage and high-stage UTUC
• discuss and compare the risk, benefit, and side effects of laparoscopic and open radical
nephroureterectomy
• understand the management of the bladder cuff
• understand the current role of multimodal therapy for high risk patients- integration of systemic therapy –
neo-adjuvant vs. adjuvant treatment
• discuss the need and boundaries of the recommended lymph node dissection
EAU Milan 2013
361
ESU Courses