Non-metastatic upper urinary tract carcinoma (UTUC) is a comparatively rare condition, typically managed with either kidney-sparing surgery (KSS) or radical nephroureterectomy (RNU). Irrespective of the chosen therapeutic modality, patients with UTUC remain at risk of recurrence in the bladder; in patients treated with KSS, the risk of recurrence is high in the remnant ipsilateral upper tract system but there is a low but existent risk in the contralateral system as well as in the chest and in the abdomen/pelvis. For patients treated with RNU for high-risk UTUC, the risk of recurrence in the chest, abdomen, and pelvis, as well as the contralateral UT, depends on the tumor stage, grade, and nodal status. Hence, implementing a risk-stratified, location-specific follow-up is indicated to ensure timely detection of cancer recurrence. However, there are no data on the type and frequency/schedule of follow-up or on the impact of the recurrence type and site on outcomes; indeed, it is not well known whether imaging-detected asymptomatic recurrences confer a better outcome than recurrences detected due to symptoms/signs. Novel imaging techniques and more precise risk stratification methods based on time-dependent probabilistic events hold significant promise for making a cost-efficient individualized, patient-centered, outcomes-oriented follow-up strategy possible. We show and discuss the follow-up protocols of the major urologic societies.
非转移性上尿路尿路上皮癌（UTUC）是一种相对罕见的疾病，通常采用保留肾脏手术（KSS）或根治性肾输尿管切除术（RNU）进行治疗。无论选择何种治疗方式，UTUC患者均存在膀胱复发的风险；对于接受KSS治疗的患者，同侧残余上尿路系统的复发风险较高，而对侧系统以及胸部和腹部/盆腔的复发风险虽低但仍存在。对于因高危UTUC接受RNU治疗的患者，胸部、腹部、盆腔以及对侧UT的复发风险取决于肿瘤分期、分级和淋巴结状态。因此，实施风险分层、部位特异性的随访对于确保及时发现癌症复发至关重要。然而，目前尚无关于随访类型和频率/时间表的数据，也缺乏关于复发类型和部位对预后影响的信息；事实上，影像学检测到的无症状复发是否比因症状/体征检测到的复发具有更好的预后尚不明确。新型影像学技术和基于时间依赖性概率事件的更精确风险分层方法，为实现成本效益高、以患者为中心、以预后为导向的个体化随访策略带来了重要希望。本文展示并讨论了主要泌尿外科学会的随访方案。
肿瘤(癌症)患者之家