Collaborative Research Networks as a Platform for Virtual Multidisciplinary, International Approach to Managing Difficult Clinical Cases: An Example from the Upper Tract Urothelial Carcinoma Collaboration

摘要

Radical nephroureterectomy (RNU) with excision of bladder cuff remains the standard of care for patients diagnosed with invasive and high-risk noninvasive urothelial carcinoma of the upper tract (UTUC) [1,2]. Despite its durable, long-term, disease control in patients with early-stage disease, the 5-yr cancer-specific survival (CSS) of RNU patients with non-organ-confined UTUC ranges from 12% to 54% [3]. While patients with pT4 or N+ UTUC are generally recommended to receive adjuvant, cisplatin-based, combination chemotherapy when eligible [4,5], the role of adjuvant chemotherapy in patients with pT3 Nx/NO UTUC remains highly debated [4-6]. Indeed, there is no high-level evidence for or against perioperative chemotherapy in UTUC, and it is unlikely that there will ever be any, due to the rarity of this disease.