Upper urinary tract transitional cell carcinoma (UTTCC) accounts for up to 10% of neoplasms of the upper urinary tract. The “gold standard” management of UTTCC is nephroureterectomy. Technological innovations, miniaturisation and increased availability of energy sources, such as Holmium laser, have improved the armamentarium of the endoscopic management of UTTCC. These advances have also led to an increase in the application of these techniques to manage UTTCC.
All published data however are small, single-centre, retrospective with a short follow-up and show high recurrence rates. In addition, although the concept has been widely accepted, there remains controversy over the selection of patients and the appropriate application of treatment and surveillance. Until large prospective studies with long follow-up are available, endoscopic management of UTTCC cannot be recommended as an alternative to nephroureterectomy.
This audit aims to produce a large, prospectively collected, multi-centre set of data which should answer the question as to whether endoscopic management of UTTCC can be performed safely and effectively with preservation of renal tissue.
Imperative reasons to perform endoscopic management could include patients who would be rendered dependent on renal replacement therapy if they underwent radical surgery or patients who are medically unfit for radical surgery. For these reasons an assessment of co-morbidity is necessary to demonstrate this association.
This audit is available on the BAUS Data and Audit System from 19 January 2011.
The full dataset is available here for information but all data must be returned using the on line system.
Login to the Data and Audit System is separate from your login to the BAUS website. For the Data and Audit (Nuvola) System your username is the email address BAUS holds for you - if you have forgotten your password use the "Forgotten password" link and a new password will be sent to you.
Patient Data entry and follow-up
Data can be added prospectively for new patients you are treating by using the prospective complex operation form. You will be reminded to fill in the follow-up data sheet by email after 6 months from your last entry.
PLEASE NOTE: We do not know what the standard follow-up should be for these patients. It possibly is not 6 months. We would be very grateful if you could remember to fill in follow-up data sheets even if actual follow-up is not at 6 months.
The inclusion of retrospective data is also possible and extremely useful. It is possible to add a new patient already on follow-up. Please use the complex operation form (marked prospective) for the first endoscopic operation on each patient as this form includes presenting symptom and investigation data.
It is proposed that the first data assessment will be approximately 3 years after the commencement and then again at 5 and 10 years.