Shvero Asaf, Carmona Orel, Zilberman Dorit E, Dotan Zohar A, Haifler Miki, Kleinmann Nir
The Department of Urology, Sheba Medical Center, Ramat Gan 5262000, Israel.
The Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
J Pers Med. 2023 Mar 28;13(4):591. doi: 10.3390/jpm13040591.
Up-to-date guidelines on the management of upper tract urothelial carcinoma (UTUC) are continuously published. We aim to assess the variability of diagnosis and treatment strategies in the endoscopic management of UTUC and adherence to European Association of Urology and National Comprehensive Cancer Network guidelines. A 15-question survey was designed to query practitioners on approaches to clinical practice and knowledge about endoscopic treatment indications and techniques. It was emailed to all members of the Endourologic Society through the society's office, and to all Israeli non-member endourologists. Eighty-eight urologists participated in the survey. Adherence to guidelines on indications for endoscopic management was only 51%. Most of the survey respondents (87.5%) use holmium laser for tumor ablation, and ~50% use forceps for biopsy while the other half use baskets. Only 50% stated that they would use Jelmyto for specific indications. Most (80%) indicated that they repeat the ureteroscopy 3 months after the first one, and 52.3% continue with follow-up ureteroscopy every 3 months during the first year after diagnosis. There is vast variability among endourologists in the technical aspects of UTUC, the indications for endoscopic management, and adherence to the available guidelines for managing UTUC.
关于上尿路尿路上皮癌（UTUC）管理的最新指南不断发布。我们旨在评估UTUC内镜治疗中诊断和治疗策略的变异性以及对欧洲泌尿外科学会和美国国立综合癌症网络指南的遵循情况。设计了一项包含15个问题的调查，以询问从业者的临床实践方法以及关于内镜治疗适应症和技术的知识。该调查通过学会办公室发送给了腔内泌尿外科协会的所有成员，以及所有以色列非会员腔内泌尿外科医生。88位泌尿外科医生参与了此次调查。对内镜治疗适应症指南的遵循率仅为51%。大多数调查受访者（87.5%）使用钬激光进行肿瘤消融，约50%使用活检钳进行活检，另一半使用活检篮。只有50%表示他们会在特定适应症下使用Jelmyto。大多数人（80%）表示他们会在首次输尿管镜检查后3个月重复进行输尿管镜检查，52.3%在诊断后的第一年每3个月继续进行输尿管镜随访。腔内泌尿外科医生在UTUC的技术方面、内镜治疗适应症以及对UTUC现有管理指南的遵循情况存在很大差异。
