{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T12:35:57Z","timestamp":1765370157691,"version":"build-2065373602"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T00:00:00Z","timestamp":1674432000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify clinicopathological or radiological factors that may predict a diagnosis of upper urinary tract urothelial cell carcinoma (UTUC) to inform which patients can proceed directly to radical nephroureterectomy (RNU) without the delay for diagnostic ureteroscopy (URS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>All consecutive patients investigated for suspected UTUC in a high\u2010volume UK centre between 2011 and 2017 were identified through retrospective analysis of surgical logbooks and a prospectively maintained pathology database. Details on clinical presentation, radiological findings, and URS\/RNU histopathology results were evaluated. Multivariate regression analysis was performed to evaluate predictors of a final diagnosis of UTUC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In all, 260 patients were investigated, of whom 230 (89.2%) underwent URS. RNU was performed in 131 patients (50.4%), of whom 25 (9.6%) proceeded directly without URS \u2013 all of whom had a final histopathological diagnosis of UTUC \u2013 and 15 (11.5%) underwent RNU after URS despite no conclusive histopathological confirmation of UTUC. Major surgery was avoided in 77 patients (33.5%) where a benign or alternative diagnosis was made on URS, and 14 patients (6.1%) underwent nephron\u2010sparing surgery. Overall, 178 patients (68.5%) had a final diagnosis of UTUC confirmed on URS\/RNU histopathology. On multivariate logistic regression analysis, a presenting complaint of visible haematuria (hazard ratio [HR] 5.17, confidence interval [CI] 1.91\u201314.0;\n                      <jats:italic>P<\/jats:italic>\n                      =\u20090.001), a solid lesion reported on imaging (HR 37.8, CI\u2009=\u200911.7\u2013122.1;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;\u20090.001) and a history of smoking (HR 3.07, CI 1.35\u20136.97;\n                      <jats:italic>P<\/jats:italic>\n                      =\u20090.007), were predictive of a final diagnosis of UTUC. From this cohort, 51 (96.2%) of 53 smokers who presented with visible haematuria and who had a solid lesion on computed tomography urogram had UTUC on final histopathology.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We identified specific factors which may assist clinicians in selecting which patients may reliably proceed to RNU without the delay of diagnostic URS. These findings may inform a prospective multicentre analysis including additional variables such as urinary cytology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.15945","type":"journal-article","created":{"date-parts":[[2022,12,10]],"date-time":"2022-12-10T11:43:35Z","timestamp":1670672615000},"page":"755-762","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Diagnostic evaluation of upper tract urothelial carcinoma: can we safely omit diagnostic ureteroscopy?"],"prefix":"10.1111","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0131-8064","authenticated-orcid":false,"given":"Matthew","family":"Trail","sequence":"first","affiliation":[{"name":"Department of Urology Western General Hospital  Edinburgh UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad Sajid Waheed","family":"Rahman","sequence":"additional","affiliation":[{"name":"College of Medicine and Veterinary Medicine The University of Edinburgh  Edinburgh UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William J.","family":"Broadhurst","sequence":"additional","affiliation":[{"name":"College of Medicine and Veterinary Medicine The University of Edinburgh  Edinburgh UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7267-837X","authenticated-orcid":false,"given":"James P.","family":"Blackmur","sequence":"additional","affiliation":[{"name":"Department of Urology Western General Hospital  Edinburgh UK"},{"name":"Centre for Genomic &amp; Experimental Medicine, Institute of Genetics and Cancer The University of Edinburgh  Edinburgh UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abhishek","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Urology Western General Hospital  Edinburgh UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Etienne","family":"Chew","sequence":"additional","affiliation":[{"name":"College of Medicine and Veterinary Medicine The University of Edinburgh  Edinburgh UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie","family":"O'Donnell","sequence":"additional","affiliation":[{"name":"Department of Histopathology Western General Hospital  Edinburgh UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julian Y.","family":"Keanie","sequence":"additional","affiliation":[{"name":"Department of Radiology Western General Hospital  Edinburgh UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Brush","sequence":"additional","affiliation":[{"name":"Department of Radiology Western General Hospital  Edinburgh UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Radiology Western General Hospital  Edinburgh UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Phipps","sequence":"additional","affiliation":[{"name":"Department of Urology Western General Hospital  Edinburgh UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ben","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Urology Western General Hospital  Edinburgh UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9766-3032","authenticated-orcid":false,"given":"Edward A.A.","family":"Mains","sequence":"additional","affiliation":[{"name":"Department of Urology Western General Hospital  Edinburgh UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. Alan","family":"McNeill","sequence":"additional","affiliation":[{"name":"Department of Urology Western General Hospital  Edinburgh UK"},{"name":"College of Medicine and Veterinary Medicine The University of Edinburgh  Edinburgh UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steve","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Urology Western General Hospital  Edinburgh UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark L.","family":"Cutress","sequence":"additional","affiliation":[{"name":"Department of Urology Western General Hospital  Edinburgh UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7296-025X","authenticated-orcid":false,"given":"Alexander","family":"Laird","sequence":"additional","affiliation":[{"name":"Department of Urology Western General Hospital  Edinburgh UK"},{"name":"Centre for Genomic &amp; Experimental Medicine, Institute of Genetics and Cancer The University of Edinburgh  Edinburgh UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,1,23]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21332"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-019-02875-8"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2019.09.008"},{"key":"e_1_2_6_5_1","unstructured":"EAU Guidelines on Upper Urinary Tract Urothelial Carcinoma 2022. 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