Place de la chirurgie conservatrice dans le traitement des tumeurs de la voie excrétrice urinaire supérieure

Urothelial carcinomas of the upper urinary tract (UUT-UCs) are rare and represent about 5% of all urothelial carcinomas. The standard treatment is still open radical nephroureterectomy. Low-grade and non-invasive UUT-UCs have a favourable outcome as non-muscle invasive bladder carcinomas (80% specific - survival rate at 5 years). First-line conservative treatment is being increasingly performed in patients with a normal controlateral kidney for surgical management of UUT-UCs. Conservative surgical management allows for kidney preservation contingent upon it is technically feasible to achieve. Conservative procedures (i.e., flexible ureteroscopy or open conservative surgery) for the treatment of superficial or low grade UUT-UCs have good outcomes and are therefore an alternative to open radical surgery. The important cost of the endoscopic techniques remains currently a limiting factor for the spread of the technique in France.