Mori Kazuyuki, Hatakeyama Shingo, Enokida Hideki, Miyake Hideaki, Kikuchi Eiji, Nishiyama Hiroyuki, Ichikawa Tomohiko, Kamai Takao, Kaji Yasushi, Kume Haruki, Kondo Tsunenori, Matsuyama Hideyasu, Masumori Naoya, Kawauchi Akihiro, Takenaka Atsushi, Uemura Hirotsugu, Eto Masatoshi, Nonomura Norio, Fujii Yasuhisa, Hinotsu Shiro, Ohyama Chikara
Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan.
Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima, Japan.
Int J Urol. 2024 Mar;31(3):194-207. doi: 10.1111/iju.15362. Epub 2023 Dec 19.
This article is an English translation of the Clinical Practice Guidelines for Upper Tract Urothelial Carcinoma (2nd edition) published in June 2023. The Japanese Urological Association's (JUA) Guidelines Committee on Upper Tract Urothelial Carcinoma (UTUC) created a 2023 update guideline to support clinicians' current evidence-based management of UTUC and to incorporate its recommendations into clinical practice. The new guideline adhered as closely as possible to the Minds Manual for Guideline Development 2020 ver. 3.0. Findings related to epidemiological, pathological, diagnosis, treatment, and follow-up were reviewed. In addition, seven clinical questions (CQs) were set to determine the grade of recommendation and level of evidence. Preconceptions and biases were removed from the preparation process, the overall evidence was evaluated appropriately, and recommendations were made after fully considering the balance between benefits and harms. Although the evidence is still insufficient to be taken up as a CQ, the latest important information is described in seven columns, and clinical issues that should be resolved in the future related to the CQ are described as recommendations for tomorrow. We hope that these guidelines will help medical professionals, patients, and their families involved in the treatment of UTUC in their decision-making, and hope that a critical review of these guidelines will lead to further refinements in the next edition.
本文是2023年6月发布的《上尿路尿路上皮癌临床实践指南(第2版)》的英文译文。日本泌尿外科学会(JUA)上尿路尿路上皮癌(UTUC)指南委员会制定了2023年更新指南,以支持临床医生目前对UTUC进行循证管理,并将其建议纳入临床实践。新指南尽可能严格遵循《2020版3.0指南制定思维手册》。对与流行病学、病理学、诊断、治疗及随访相关的研究结果进行了审查。此外,还设定了七个临床问题(CQs)以确定推荐等级和证据水平。在制定过程中消除了先入之见和偏见,对整体证据进行了适当评估,并在充分考虑利弊平衡后提出了建议。尽管证据仍不足以作为一个CQ纳入,但最新的重要信息在七个专栏中进行了描述,与CQ相关的未来应解决的临床问题则作为明日建议进行了阐述。我们希望这些指南将有助于参与UTUC治疗的医学专业人员、患者及其家属进行决策,并希望对这些指南的批判性审查能在下一版中带来进一步完善。