Editing AUA: Upper Tract Urothelial Carcinoma (2023) (section)

==== Watchful waiting or surveillance ====

*May be offered to select patients with UTUC with 
**Significant comorbidities/competing risks of mortality
**Significant risk of End-Stage Renal Disease (ESRD) with any intervention resulting in dialysis.
*Discussion of treatment related risks including perioperative mortality may lead to a shared decision to proceed with active surveillance (whereby periodic assessments such as imaging or limited endoscopic assessment are performed) or watchful waiting/expectant management, where interventions are limited to palliation or awaiting symptomatic progression – especially in those with very limited life expectancy. 
**In such cases, patients and family should be counseled and prepared for disease-related events such as bleeding, obstruction, infection, and pain with options for palliation that may be limited.