Summary of the Clinical Practice Guidelines for Upper Tract Urothelial Carcinoma 2023 by the Japanese Urological Association
Kazuyuki Mori, Shingo Hatakeyama, Hideki Enokida, Hideaki Miyake, Eiji Kikuchi, Hiroyuki Nishiyama, Tomohiko Ichikawa, Takao Kamai, Yasushi Kaji, Haruki Kume, Tsunenori Kondo, Hideyasu Matsuyama, Naoya Masumori, Akihiro Kawauchi, Atsushi Takenaka, Hirotsugu Uemura, Masatoshi Eto, Norio Nonomura, Yasuhisa Fujii, Shiro Hinotsu, Chikara Οhyama
Abstract
This article is an English translation of the Clinical Practice Guidelines for Upper Tract Urothelial Carcinoma (2nd edition) published in June 2023. The Japanese Urological Association's (JUA) Guidelines Committee on Upper Tract Urothelial Carcinoma (UTUC) created a 2023 update guideline to support clinicians' current evidence-based management of UTUC and to incorporate its recommendations into clinical practice. The new guideline adhered as closely as possible to the Minds Manual for Guideline Development 2020 ver. 3.0. Findings related to epidemiological, pathological, diagnosis, treatment, and follow-up were reviewed. In addition, seven clinical questions (CQs) were set to determine the grade of recommendation and level of evidence. Preconceptions and biases were removed from the preparation process, the overall evidence was evaluated appropriately, and recommendations were made after fully considering the balance between benefits and harms. Although the evidence is still insufficient to be taken up as a CQ, the latest important information is described in seven columns, and clinical issues that should be resolved in the future related to the CQ are described as recommendations for tomorrow. We hope that these guidelines will help medical professionals, patients, and their families involved in the treatment of UTUC in their decision-making, and hope that a critical review of these guidelines will lead to further refinements in the next edition.