Guidelines

Upper Urinary Tract Urothelial Cell Carcinoma

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2. METHODS

2.1. Data identification

For the 2026 UTUC Guidelines, new and relevant evidence has been identified, collated and appraised through a structured assessment of the literature. The search was restricted to articles published between 1 May 2024 and 1 May 2025. Databases searched included PubMed, Ovid, EMBASE and both the Cochrane Central Register of Controlled Trials and the Cochrane Database of Systematic Reviews. After deduplication, a total of 417 unique records were identified, retrieved and screened for relevance. A detailed search strategy is available on the EAU website: https://uroweb.org/guidelines/upper-urinary-tract-urothelial-cell-carcinoma/publications-appendices.

Recommendations within the Guidelines are developed by the Panels to prioritise clinically important care decisions. The strength of each recommendation is determined by the balance between desirable and undesirable consequences of alternative management strategies, the quality of the evidence (including certainty of estimates), and the nature and variability of patient values and preferences. This decision process, which can be reviewed in the strength rating forms that accompany each guideline recommendation, addresses a number of key elements:

  1. the overall quality of the evidence that exists for the recommendation [5]
  2. the magnitude of the effect (individual or combined effects)
  3. the certainty of the results (precision, consistency, heterogeneity and other statistical or study-related factors)
  4. the balance between desirable and undesirable outcomes
  5. the impact and certainty of patient values and preferences on the intervention.

Strong recommendations typically indicate a high degree of evidence quality and/or a favourable balance of benefit to harm and patient preference. Weak recommendations typically indicate availability of lower quality evidence and/or equivocal balance between benefit and harm, and uncertainty or variability of patient preference [6].

Additional methodology information and a list of associations endorsing the EAU Guidelines can be found on the EAU website: https://uroweb.org/eau-guidelines/methodology-policies.

2.2. Review

The UTUC Guidelines were subject to peer-review prior to publication in 2023.