Upper Urinary Tract Urothelial Cell Carcinoma

Full Text Guidelines Summary of Changes Scientific Publications & Appendices Pocket Guidelines Archive Panel

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M. Rouprêt,, M. Babjuk, A. Böhle, M. Burger, E. Compérat, N. Cowan, E. Kaasinen, J. Palou, B.W.G. van Rhijn, R. Sylvester, R. Zigeuner, S.F. Shariat
Guidelines Associates: M. Bruins, J.L. Dominguez-Escrig, B. Peyronnet, T. Seisen


1.1.Aims and objective

The European Association of Urology (EAU) Non-muscle-invasive Bladder Cancer (NMIBC) Guidelines Panel has compiled these clinical guidelines to provide urologists with evidence-based information and recommendations for the management of urothelial carcinoma of the upper urinary tract (UTUC).

It must be emphasised that clinical guidelines present the best evidence available to the experts but following guideline recommendations will not necessarily result in the best outcome. Guidelines can never replace clinical expertise when making treatment decisions for individual patients, but rather help to focus decisions - also taking personal values and preferences/individual circumstances of patients into account.

1.2.Panel composition

The European Association of Urology (EAU) Guidelines Panel on NMIBC consists of an international multidisciplinary group of clinicians, including a pathologist and a statistician. Members of this panel have been selected based on their expertise and to represent the professionals treating patients suspected of harbouring urothelial carcinoma.

All experts involved in the production of this document have submitted potential conflict of interest statements, which can be viewed on the EAU website Uroweb: http://uroweb.org/guideline/upper-urinary-tract-urothelial-cell-carcinoma/.

1.3.Available publications

A quick reference document (Pocket guidelines) is available in print and in a number of versions for mobile devices, presenting the main findings of the UTUC Guidelines. These are abridged versions which may require consultation together with the full text version. Several scientific publications are available as are a number of translations of all versions of the EAU UTUC Guidelines. All documents can be viewed on the EAU website: http://uroweb.org/guideline/upper-urinary-tract-urothelial-cell-carcinoma/.

1.4.Publication history & summary of changes

The first EAU guidelines on UTUC were published in 2011. The 2016 EAU guidelines on UTUC presents an update of the 2015 version.

1.4.1.Summary of changes

The literature for the complete document has been assessed and updated, whenever relevant. Conclusions and recommendations have been rephrased and added to throughout the current document.

Key changes for the 2016 print:

Changed or new conclusions and recommendations can be found in sections:

  • Section 6.2 Molecular markers has been added as a new topic.
  • Section 6.4 Bladder recurrence has been added as a new topic.

New recommendations have been included in Chapter 6 - Prognosis

6.6 Summary of evidence and guidelines for prognosis

Summary of evidence


Age, sex and ethnicity are no longer considered as independent prognostic factors.


The primary recognised post-operative prognostic factors are tumour stage and grade, extranodal extension and lymphocascular invasion.





Use MSI as an independent molecular prognostic marker to help detect germline mutations and hereditary cancers.



Use the American Society of Anesthesiologists (ASA) score to assess cancer-specific survival following surgery.



MSI=Microsatellite instability.

In section Laparoscopic radical nephrectomy, the findings of the Systematic review have been included (see below).

Section 7.2.2 Systemic chemotherapy has been expanded.

A new algorithm - Figure 7.2 Surgical treatment according to location and risk status - has been included.