{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T10:04:05Z","timestamp":1784714645812,"version":"3.55.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.de"},{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.de"}],"funder":[{"DOI":"10.13039\/501100012681","name":"Universit\u00e4tsklinikum K\u00f6ln","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100012681","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Urologie"],"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Hintergrund<\/jats:title>\n                    <jats:p>Das Urothelkarzinom des oberen Harntrakts (UTUC) erfordert einen komplexen, multimodalen und leitlinienbasierten Therapieansatz. Aufgrund der Seltenheit der Erkrankung, geringer Fallzahlen und diagnostischer Herausforderungen ist die Umsetzung der j\u00e4hrlich aktualisierten EAU-Leitlinien (European Association of Urology) im klinischen Alltag jedoch h\u00e4ufig erschwert. Ziel dieser Studie war die Evaluation der leitliniengerechten Versorgung sowie der Einfluss leitlinienabweichender Therapieentscheidungen auf das onkologische Outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodik<\/jats:title>\n                    <jats:p>In einer retrospektiven Analyse wurden 181\u00a0Patient:innen mit UTUC untersucht, die zwischen 2011 und 2024 an unserer Klinik behandelt wurden. Diagnostik, Therapie und onkologisches Outcome wurden anhand der jeweils g\u00fcltigen EAU-Leitlinien bewertet und die Behandlungsverl\u00e4ufe in Abh\u00e4ngigkeit von der Leitlinientreue analysiert.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ergebnisse<\/jats:title>\n                    <jats:p>\n                      Eine nicht leitlinienkonforme Diagnostik oder Therapie erhielten 13\u202f% der Patient:innen. Hauptursachen waren die fehlende Resektion der Blasenmanschette (52\u202f%), das Ausbleiben einer adjuvanten Chemotherapie (32\u202f%, 2020\u20132024), das Fehlen einer interdisziplin\u00e4ren Tumorboard-Besprechung (17\u202f%) sowie operative Untertherapie (5\u202f%). Die fehlende Blasenmanschettenresektion war mit einem signifikant reduzierten Gesamt\u00fcberleben (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u20090,047) und einer erh\u00f6hten Rezidivrate (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u20090,038) assoziiert. Zudem zeigten sich wiederholt Abweichungen in der umfassenden Diagnostik zur korrekten Einteilung in Low-risk- und High-risk-Patient:innen.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Schlussfolgerung<\/jats:title>\n                    <jats:p>Trotz klarer Empfehlungen der EAU bleibt deren Umsetzung im klinischen Alltag herausfordernd. Eine leitliniengerechte Versorgung ist jedoch essenziell, da Abweichungen mit einem signifikant schlechteren onkologischen Outcome einhergehen.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00120-026-02878-5","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T09:33:37Z","timestamp":1784712817000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostik und Therapie des Urothelkarzinoms des oberen Harntrakts: Evaluation einer Leitliniencompliance 2011\u20132024","Diagnosis and treatment of upper tract urothelial carcinoma: assessment of guideline compliance from 2011\u20132024"],"prefix":"10.1007","author":[{"given":"Felix","family":"P\u00fctz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wiebke","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Heidenreich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia","family":"Paffenholz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"issue":"5","key":"2878_CR1","first-page":"476","volume":"5","author":"B Alm\u00e5s","year":"2024","unstructured":"Alm\u00e5s\u00a0B et\u00a0al (2024) Eine pr\u00e4operative Magnetresonanztomographie kann bei der Stadieneinteilung und Behandlungswahl des urothelialen Karzinoms des oberen Trakts helfen. BJUI-Kompass 5(5):476\u2013482","journal-title":"BJUI-Kompass"},{"issue":"11","key":"2878_CR2","doi-asserted-by":"publisher","first-page":"2755","DOI":"10.1007\/s00345-022-04168-z","volume":"40","author":"J Baard","year":"2022","unstructured":"Baard\u00a0J et\u00a0al (2022) Adh\u00e4renz an Leitlinienempfehlungen beim Management des Urothelkarzinoms des oberen Harntrakts: eine Analyse des CROES\u2013UTUC-Registers. World J Urol 40(11):2755\u20132763","journal-title":"World J Urol"},{"issue":"1","key":"2878_CR3","first-page":"177","volume":"42","author":"J Baard","year":"2024","unstructured":"Baard\u00a0J et\u00a0al (2024) Enth\u00fcllung der Herausforderungen von UTUC-Biopsien und Zytologie: Erkenntnisse aus einer globalen Praxisstudie. 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Von allen beteiligten Patient\/-innen liegt eine Einverst\u00e4ndniserkl\u00e4rung vor.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Einhaltung ethischer Richtlinien"}}]}}