Kidney-Sparing Management Versus Nephroureterectomy for Upper Tract Urothelial Carcinoma: a Meta-Analysis

Upper tract urothelial carcinoma (UTUC) is rare and occupied 5% of the urothelial carcinoma (Munoz and Ellison, 2000; Siegel et al., 2013). The standard treatment of UTUC is nephroureterectomy (NU) with bladder cuff resection which means one kidney would be lost after this extirpative management. It yields high risk of followed chronic kidney disease and makes following pharmacotherapy treatment restricted because of impaired renal function (Malcolm et al., 2009). Renal function preservation is becoming recognized and kidney-sparing procedures are reserved for selected patients with lowgrade UTUC in EAU guidelines (Roupret et al., 2013). Kidney-sparing management (KS) has been reported with durable prognostic outcomes as nephroureterectomy in several studies (Gadzinski et al., 2010; Jeldres et al., 2010; Cutress et al., 2013; Fukushima et al., 2014). Kidney preservation treatments mainly comprise segmental ureterectomy and endoscopic resection or ablation. With the advance of endoscopic techniques, these conservative managements become popular for UTUC treatment.