Management of urothelial carcinomas of the upper tract: Audit of 2-year follow-up of patients undergoing Nephroureterectomy
BAUS ePoster online library. Ng M. Jun 25, 2019; 265253; CU-10 Disclosure(s): Nothing to disclose
Dr. Michael Ng
Dr. Michael Ng
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Abstract
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Objectives: To determine how current follow-up strategies following radical nephroureterectomy (for urothelial carcinoma) compare with European guidelines (EAU).

Methods: Retrospective audit of case notes of 31 patients who met eligibility criteria and underwent Nephroureterectomy between 2014-2016 were identified. 2-year Cystoscopic and radiological follow-up data was collected and analysed to determine how follow-up compared to EAU guidelines.

Results: Average time from MDT to first follow-up cystoscopy was 3.8 months. Only 65% (n=15) patients had cystoscopic follow-up within 3 months (as recommended by EAU guidelines). 21.7% of patients had cystoscopic follow-up at 6 months. Patients attended an average of 4 follow-up cystoscopy's over the 2 year period. CTU made up only 25% of surveillance cross-sectional imaging in our hospital.

Conclusions: In our single-centre study, we observed a high degree of variation in cystoscopic follow-up between patients. Average cystoscopic follow-up was 4 cystoscopy's in 24 months (the equivalent of 6 monthly vs EAU recommended 3 monthly). To continue to meet current EAU guidelines changes will therefore need to be made to improve the rate of cystoscopic follow-up. This audit demonstrated follow-up can be improved in our hospital; this could be achieved by introducing standardised follow-up options on operation notes.




Introduction
Upper tract urothelial carcinomas although uncommon, account for upto 10% of urothelial carcinomas1,2. These patients are at particularly high risk of recurrence, with bladder recurrence rates ranging from 22-47%1,3. Close follow-up of these patients is therefore essential due to the risk of recurrence (bladder tumours, local recurrence and metastases). Current EAU guidelines recommend close cystoscopic surveillance and cross-sectional follow-up after radical nephroureterectomy (with cystoscopic follow-up 3 monthly for 2 years and cross-sectional surveillance 6 mont
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