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

==== Surveillance after kidney sparing ====

* '''Low-risk patients managed with kidney sparing treatment''' 
** Cystoscopy and upper tract endoscopy within 1-3 months of treatment to confirm successful treatment.
**If successful treatment confirmed (no evidence of disease), perform
***Cystoscopy of the bladder once again within the first year after treatment, then at least every 6-9 months for the first 2 years and then at least annually thereafter.
***Upper tract endoscopy at 6 months and 1 year [after treatment]. 
****Can be subsequently performed for any symptoms or significant findings on upper tract imaging.
***Upper tract imaging should be performed at least every 6-9 months for first 2 years, then annually up to 5 years.
***Surveillance after 5 years in the absence of recurrence should be based on shared decision-making.
**No distant metastatic evaluation since risk is low with low-risk disease
* '''High-risk patients managed with kidney sparing treatment''' 
** Cystoscopy, upper tract endoscopy, and upper tract urine cytology within 1-3 months of treatment to confirm successful treatment.
**If successful treatment confirmed (no evidence of disease), perform
***Cystoscopy of the bladder and cytology at least every 3-6 months for the first 3 years and then every 6-12 months up to 5 years.
***Upper tract endoscopy should be performed at least at 6 months and 1 year [after treatment]
***Upper tract imaging and BMP should be performed every 3-6 months for 3 years, then every 6-12 months for 2 years, and then annually thereafter.
***Distant metastatic evaluation: Chest imaging (chest X-ray or CT) is recommended every 6-12 months to evaluate for intrathoracic metastasis up to 5 years following last diagnosis/treatment
***Surveillance after 5 years in the absence of recurrence should be based on shared decision-making.
* '''If patient develops urothelial recurrence in the bladder or urethra or positive cytology following kidney sparing treatment for UTUC, evaluate for possible ipsilateral recurrence or development of new contralateral upper tract disease.'''