Adherence to guideline recommendations in the management of upper tract urothelial carcinoma: An analysis of the CROES-UTUC registry

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dc.contributor.authorBaard, Joyce
dc.contributor.authorShariat, Shahrokh F.
dc.contributor.authorRoupret, Morgan
dc.contributor.authorYoshida, Takashi
dc.contributor.authorSaita, Alberto
dc.contributor.authorSaltirov, Iliya
dc.contributor.authorBurgos, Javier Revilla
dc.contributor.authorÇelik, Orçun
dc.contributor.authorde la Rosette, Jean J. M. C. H.
dc.contributor.authordel Pilar Laguna Pes, Maria
dc.date.accessioned2022-12-15T12:39:25Z
dc.date.available2022-12-15T12:39:25Z
dc.date.issued2022
dc.departmentİstanbul Medipol Üniversitesi, Uluslararası Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Üroloji Ana Bilim Dalı
dc.description.abstractBackground: The European Association of Urology provides Clinical Practice Guideline on upper tract urothelial carcinoma (UTUC). Due to the rarity of UTUC, guidelines are necessary to help guide decision-making based on the highest quality of care evidence available. Objectives: To evaluate guideline adherence in the management of UTUC by assessing recommendations on diagnostics needed for risk classification and subsequent treatment selection; to assess predictors for the latter. Participants: Data from the Clinical Research Office of the Endo Urology Society UTUC-registry were included for analysis. Statistical analysis: Overall compliance were evaluated by cross-tables, differences in risk groups characteristics and treatment selection were assessed by Chi-square tests, predictors for treatment selection by logistic regression analysis. Results: Data from 2380 patients were included. Imaging by CT-scan had highest adherence (85%) but was low for other diagnostics (17.7–49.7%). Multivariable regression analysis showed higher odds of receiving radical nephroureterectomy in patients with large tumours (OR 5.45, 95% CI 3.77–7.87, p < 0.001), signs of invasion (OR 3.07,CI 2.11–4.46, p < 0.001), high tumour grade (OR 2.05, CI 1.38–3.05, p < 0.001) and multifocality (OR 1.76,CI 1.05–2.97, p =0.032). Conclusions: CT-imaging is the most used and most impactful decision tool for risk-stratification and treatment selection in UTUC. Due to the low compliance in most of the diagnostic recommendations, proper risk stratification is not possible in a significant group of patients raising the question whether current stratification is deemed applicable in daily practice. Established prognostic factors on survival guides decision-making regarding radical versus kidney-sparing surgery. Tumour size was the most influencing factor on treatment decision. Clinical trial registration: The study was registered at ClinicalTrials.gov (ClinicalTrials.gov NCT02281188; https://clinicaltrials.gov/ct2/show/NCT02281188).
dc.identifier.citationBaard, J., Shariat, S. F., Roupret, M., Yoshida, T., Saita, A., Saltirov, I. ... del Pilar Laguna Pes, M. (2022). Adherence to guideline recommendations in the management of upper tract urothelial carcinoma: An analysis of the CROES-UTUC registry. World Journal of Urology, 40(11), 2755-2763. https://doi.org/10.1007/s00345-022-04168-z
dc.identifier.doi10.1007/s00345-022-04168-z
dc.identifier.endpage2763
dc.identifier.issn0724-4983
dc.identifier.issn1433-8726
dc.identifier.issue11
dc.identifier.pmid36197507
dc.identifier.scopus2-s2.0-85139444917
dc.identifier.scopusqualityQ1
dc.identifier.startpage2755
dc.identifier.urihttps://doi.org/10.1007/s00345-022-04168-z
dc.identifier.urihttps://hdl.handle.net/20.500.12511/10131
dc.identifier.volume40
dc.identifier.wos000864308300001en_US
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorde la Rosette, Jean J. M. C. H.
dc.institutionauthordel Pilar Laguna Pes, Maria
dc.language.isoen
dc.publisherSpringer
dc.relation.ispartofWorld Journal of Urologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectClinical Practice Guidelines
dc.subjectGuidelines
dc.subjectUpper Tract Urothelial Carcinoma
dc.subjectUrothelial Carcinoma
dc.titleAdherence to guideline recommendations in the management of upper tract urothelial carcinoma: An analysis of the CROES-UTUC registry
dc.typeArticle

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