Risk-adapted strategy for the kidney-sparing management of upper tract tumours

Use of a risk-adapted approach to select patients who are more likely to benefit from conservative, kidney-sparing surgery without compromising oncological safety has been advocatedKidney-sparing surgery for the treatment of low-risk upper tract urothelial carcinoma in selected patients achieves similar oncological outcomes as radical nephroureterectomyGrowing evidence exists that a systematic endoscopic second-look after ureteroscopic and percutaneous management of upper tract urothelial carcinoma decreases the risk of local recurrence and progressionAdjuvant endocavitary instillations of topical agents might decrease the risk of local recurrence and progression after the endoscopic management of patients with upper tract urothelial carcinomaA single, early intravesical instillation of mitomycin C after kidney-sparing surgery for upper tract urothelial carcinoma might decrease the risk of recurrence in the bladderMeticulous and stringent endoscopic monitoring of the upper and lower urinary tract for recurrence is a key component of the conservative management of patients with upper tract urothelial carcinoma