What are the EAU recommendations for surveillance after treatment for UTUC bladder cancer?

Updated: Feb 23, 2021
  • Author: Kara N Babaian, MD, FACS; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

The EAU recommends follow-up for at least 5 years after treatment of UTUC; however, the surveillance schedules specified are all grade C recommendations. Surveillance schedules are as follows [145] :

  • Noninvasive tumors treated with RNU - Cystoscopy and urinary cytology at 3 months and then annually; CT annually
  • Invasive tumors treated with RNU - Cystoscopy and urinary cytology at 3 months and then annually; CT urography every 6 months over 2 years and then annually. After 5 years of recurrence free years, recurrence risk is low and cystoscopy can be replaced with a less invasive surveillance regimen.
  • If there are concerning lesions on cystoscopy, conducting endoscopy under anesthesia to obtain bladder biopsies is strongly recommended.
  • Conservatively managed tumors - Urinary cytology and CT urography at 3, 6, and 12 months and annually thereafter; cystoscopy, ureteroscopy, and cytology in situ at 3 and 6 months, then every 6 months over 2 years, then annually
  • There is a weak recommendation to conduct ultrasound if cystoscopy is not possible or refused by a patient.

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