This protocol applies to patients with upper urinary tract urothelial carcinoma (UTUC) who present with resectable clinical lymph node metastasis and no evidence of distant metastases — a specific subset for which a structured pre-surgical approach is recommended.
The patient has upper urinary tract urothelial carcinoma with clinical lymph node involvement confirmed as resectable, and staging has excluded distant metastatic disease. Guidelines support offering induction systemic therapy to patients in this setting before definitive surgical planning.
Management in this scenario involves induction platinum-based combination chemotherapy delivered prior to surgery. The specific regimen depends on individual patient eligibility — full protocol details and the complete decision pathway are available via the link below.
The primary objective is to achieve tumour response to induction chemotherapy. A meaningful response informs subsequent multidisciplinary discussion around definitive surgical management.
DOI: 10.1016/j.eururo.2025.02.023
Patients with resectable cN+ disease should be offered induction PBC.
RNU with template-based LND can be discussed in a multidisciplinary team and with patients who respond to initial systemic therapy.
View source ↗