Treatment of Renal Pelvis Cancer in Unifocal Upper Urinary Tract Urothelial Carcinoma with Low-Risk Features

This protocol covers patients with renal pelvis cancer presenting as unifocal upper urinary tract urothelial carcinoma (UTUC) that meets a specific set of low-risk criteria. In this setting, kidney-preserving strategies are the primary clinical consideration.

Patient scenario

Upper urinary tract urothelial carcinoma (UTUC)
Unifocal disease
Tumour size less than 2 cm
Negative for high-grade urine cytology
Low-grade ureteroscopy biopsy
No invasive aspect on CT imaging
No distant metastases

All of these factors need to be present.

Treatment approach

For patients meeting all of these low-risk criteria, kidney-sparing management is the primary treatment option. The approach centres on endoscopic intervention directed at complete tumour resection — the full decision framework, procedural options, and sequencing are detailed in the structured protocol.

Clinical goals

Complete tumour resection

No residual or recurrent disease on second-look ureteroscopy within 8 weeks of initial management

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.eururo.2025.02.023

Unifocal disease, Tumour size <2 cm, Negative for high-grade cytology, Low-grade URS biopsy, No invasive aspect on CT. All of these factors need to be present.

Offer kidney-sparing management as the primary treatment option to patients with low-risk tumours. Endoscopic ablation should be considered for patients with low-risk cancer. Perform second-look ureteroscopy within 8 wk after initial endoscopic management.

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