Clinical practice patterns for upper tract urothelial carcinoma: A nationwide survey in Japan

Eiji Kikuchi, Mototsugu Oya

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objective: A comprehensive survey has not yet been conducted to investigate care patterns by urologists for the management of upper tract urothelial carcinoma.Methods: We conducted a nationwide survey for urologists treating upper tract urothelial carcinoma patients. The questionnaire was approved by the Japanese Urological Association and sent by mail in February 2014 to 1119 institutes in Japan. We identified 627 responders for this study.Results: Our survey demonstrated that (i) the mean number of radical nephroureterectomy cases per institution in 2013 was 7.6, (ii) the main detecting tool for upper tract urothelial carcinoma is contrast-enhanced computed tomography, (iii) the need for ureteroscopic evaluations is highly dependent on voiding urine cytology results, (iv) 67% of urologists always or often perform radical nephroureterectomy by laparoscopic surgery, (v) more than half of the urologists do not aggressively perform lymph node dissection, (vi) 75% of the urologists perform bladder cuff incision through an extravesical approach, (vii) urologists perform kidney-sparing surgery following various indications, (viii) 59% of the urologists always perform adjuvant systemic chemotherapy for high-risk upper tract urothelial carcinoma patients, (ix) the combination of gemcitabine and cisplatin is the most frequent chemo-regimen for metastatic upper tract urothelial carcinoma, and gemcitabine and cisplatin with dose reductions is also the first choice even in patients with impaired renal function and (x) 10.5% of urologists always or sometimes perform single intravesical chemotherapy immediately after radical nephroureterectomy.Conclusions: The management strategy for upper tract urothelial carcinoma has changed with the introduction of new devices and development of instruments. The lack of clear evidence for relatively uncommon upper tract urothelial carcinoma affects the consistency of its treatment strategies.

Original languageEnglish
Article numberhyw072
Pages (from-to)768-774
Number of pages7
JournalJapanese Journal of Clinical Oncology
Volume46
Issue number8
DOIs
Publication statusPublished - 2016 Aug 1

Fingerprint

Physicians' Practice Patterns
Japan
Carcinoma
gemcitabine
Cisplatin
Kidney
Surveys and Questionnaires
Urologists
Postal Service
Adjuvant Chemotherapy
Lymph Node Excision
Laparoscopy
Cell Biology
Urinary Bladder
Tomography
Urine
Drug Therapy
Equipment and Supplies

Keywords

  • Clinical management
  • Nationwide survey
  • Renal pelvic tumor
  • Upper tract urothelial carcinoma
  • Ureteral tumor

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Clinical practice patterns for upper tract urothelial carcinoma : A nationwide survey in Japan. / Kikuchi, Eiji; Oya, Mototsugu.

In: Japanese Journal of Clinical Oncology, Vol. 46, No. 8, hyw072, 01.08.2016, p. 768-774.

Research output: Contribution to journalArticle

@article{26c37ded34e94e6e8da173984bda4f0f,
title = "Clinical practice patterns for upper tract urothelial carcinoma: A nationwide survey in Japan",
abstract = "Objective: A comprehensive survey has not yet been conducted to investigate care patterns by urologists for the management of upper tract urothelial carcinoma.Methods: We conducted a nationwide survey for urologists treating upper tract urothelial carcinoma patients. The questionnaire was approved by the Japanese Urological Association and sent by mail in February 2014 to 1119 institutes in Japan. We identified 627 responders for this study.Results: Our survey demonstrated that (i) the mean number of radical nephroureterectomy cases per institution in 2013 was 7.6, (ii) the main detecting tool for upper tract urothelial carcinoma is contrast-enhanced computed tomography, (iii) the need for ureteroscopic evaluations is highly dependent on voiding urine cytology results, (iv) 67{\%} of urologists always or often perform radical nephroureterectomy by laparoscopic surgery, (v) more than half of the urologists do not aggressively perform lymph node dissection, (vi) 75{\%} of the urologists perform bladder cuff incision through an extravesical approach, (vii) urologists perform kidney-sparing surgery following various indications, (viii) 59{\%} of the urologists always perform adjuvant systemic chemotherapy for high-risk upper tract urothelial carcinoma patients, (ix) the combination of gemcitabine and cisplatin is the most frequent chemo-regimen for metastatic upper tract urothelial carcinoma, and gemcitabine and cisplatin with dose reductions is also the first choice even in patients with impaired renal function and (x) 10.5{\%} of urologists always or sometimes perform single intravesical chemotherapy immediately after radical nephroureterectomy.Conclusions: The management strategy for upper tract urothelial carcinoma has changed with the introduction of new devices and development of instruments. The lack of clear evidence for relatively uncommon upper tract urothelial carcinoma affects the consistency of its treatment strategies.",
keywords = "Clinical management, Nationwide survey, Renal pelvic tumor, Upper tract urothelial carcinoma, Ureteral tumor",
author = "Eiji Kikuchi and Mototsugu Oya",
year = "2016",
month = "8",
day = "1",
doi = "10.1093/jjco/hyw072",
language = "English",
volume = "46",
pages = "768--774",
journal = "Japanese Journal of Clinical Oncology",
issn = "0368-2811",
publisher = "Oxford University Press",
number = "8",

}

TY - JOUR

T1 - Clinical practice patterns for upper tract urothelial carcinoma

T2 - A nationwide survey in Japan

AU - Kikuchi, Eiji

AU - Oya, Mototsugu

PY - 2016/8/1

Y1 - 2016/8/1

N2 - Objective: A comprehensive survey has not yet been conducted to investigate care patterns by urologists for the management of upper tract urothelial carcinoma.Methods: We conducted a nationwide survey for urologists treating upper tract urothelial carcinoma patients. The questionnaire was approved by the Japanese Urological Association and sent by mail in February 2014 to 1119 institutes in Japan. We identified 627 responders for this study.Results: Our survey demonstrated that (i) the mean number of radical nephroureterectomy cases per institution in 2013 was 7.6, (ii) the main detecting tool for upper tract urothelial carcinoma is contrast-enhanced computed tomography, (iii) the need for ureteroscopic evaluations is highly dependent on voiding urine cytology results, (iv) 67% of urologists always or often perform radical nephroureterectomy by laparoscopic surgery, (v) more than half of the urologists do not aggressively perform lymph node dissection, (vi) 75% of the urologists perform bladder cuff incision through an extravesical approach, (vii) urologists perform kidney-sparing surgery following various indications, (viii) 59% of the urologists always perform adjuvant systemic chemotherapy for high-risk upper tract urothelial carcinoma patients, (ix) the combination of gemcitabine and cisplatin is the most frequent chemo-regimen for metastatic upper tract urothelial carcinoma, and gemcitabine and cisplatin with dose reductions is also the first choice even in patients with impaired renal function and (x) 10.5% of urologists always or sometimes perform single intravesical chemotherapy immediately after radical nephroureterectomy.Conclusions: The management strategy for upper tract urothelial carcinoma has changed with the introduction of new devices and development of instruments. The lack of clear evidence for relatively uncommon upper tract urothelial carcinoma affects the consistency of its treatment strategies.

AB - Objective: A comprehensive survey has not yet been conducted to investigate care patterns by urologists for the management of upper tract urothelial carcinoma.Methods: We conducted a nationwide survey for urologists treating upper tract urothelial carcinoma patients. The questionnaire was approved by the Japanese Urological Association and sent by mail in February 2014 to 1119 institutes in Japan. We identified 627 responders for this study.Results: Our survey demonstrated that (i) the mean number of radical nephroureterectomy cases per institution in 2013 was 7.6, (ii) the main detecting tool for upper tract urothelial carcinoma is contrast-enhanced computed tomography, (iii) the need for ureteroscopic evaluations is highly dependent on voiding urine cytology results, (iv) 67% of urologists always or often perform radical nephroureterectomy by laparoscopic surgery, (v) more than half of the urologists do not aggressively perform lymph node dissection, (vi) 75% of the urologists perform bladder cuff incision through an extravesical approach, (vii) urologists perform kidney-sparing surgery following various indications, (viii) 59% of the urologists always perform adjuvant systemic chemotherapy for high-risk upper tract urothelial carcinoma patients, (ix) the combination of gemcitabine and cisplatin is the most frequent chemo-regimen for metastatic upper tract urothelial carcinoma, and gemcitabine and cisplatin with dose reductions is also the first choice even in patients with impaired renal function and (x) 10.5% of urologists always or sometimes perform single intravesical chemotherapy immediately after radical nephroureterectomy.Conclusions: The management strategy for upper tract urothelial carcinoma has changed with the introduction of new devices and development of instruments. The lack of clear evidence for relatively uncommon upper tract urothelial carcinoma affects the consistency of its treatment strategies.

KW - Clinical management

KW - Nationwide survey

KW - Renal pelvic tumor

KW - Upper tract urothelial carcinoma

KW - Ureteral tumor

UR - http://www.scopus.com/inward/record.url?scp=84991404857&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84991404857&partnerID=8YFLogxK

U2 - 10.1093/jjco/hyw072

DO - 10.1093/jjco/hyw072

M3 - Article

C2 - 27272173

AN - SCOPUS:84991404857

VL - 46

SP - 768

EP - 774

JO - Japanese Journal of Clinical Oncology

JF - Japanese Journal of Clinical Oncology

SN - 0368-2811

IS - 8

M1 - hyw072

ER -