NEW EAU UTUC guidelines 2024 mention urinary biomarkers

 Reviewed by Marek Babjuk and Paolo Gontero

The 2024 EAU guidelines mention a study concluding that FISH and Bladder EpiCheck® along with cytology could be helpful as an ancillary tool in the diagnosis of upper tract urothelial carcinoma (UTUC) [1].

The standard recommended tools for the diagnosis of UTUC include computed tomography (CT) urography for diagnosis and staging and a urethrocystoscopy to rule out bladder tumour [1]. If imaging and voided urine cytology are not sufficient for the diagnosis and/or risk-stratification of patients suspected to have UTUC, diagnostic ureteroscopy is recommended [1].

Despite being the standard of care for UTUC diagnosis, CT urography cannot detect carcinoma in situ (CIS) and flat lesions, and endoscopic procedures are invasive and cumbersome [2,3].

A recent prospective study in 79 patients showed promising results of urine biomarker tests (Bladder EpiCheck® and Urovysion®-FISH) and concluded that these tests could be helpful ancillary methods for the detection of UTUC [4].

→ Read our update on this study here

Despite these promising data, the low number of cases included in this study cannot allow any definitive conclusions and multicentric, randomised studies are needed.

Consequently, the guidelines, other than appraising the diagnostic value of FISH and Bladder EpiCheck® along with cytology in the detection of UTUC, also state the need for well-designed prospective comparative trials to further confirm their diagnostic utility for UTUC.

Updated slide resource

We updated our comprehensive slide resource on biomarkers and included a new section on UTUC. Click on the button below to download the slide resource. Don’t forget to share it with your colleagues as well!

[References]

1. Masson-Lecomte A, Gontero P, Birtle A, et al. European Association of Urology (EAU) guidelines on upper urinary tract urothelial carcinoma. Update April 2024. Available at: https://uroweb.org/guidelines/upper-urinary-tract-urothelial-cell-carcinoma
2. Coleman JA, Clark PE, Bixler BR, et al. Diagnosis and management of non-metastatic upper tract urothelial carcinoma: AUA/SUO guideline. J Urol 2023;209:1071-81. Update April 2023. Available at: https://www.auanet.org/guidelines-and-quality/guidelines/non-metastatic-upper-tract-urothelial-carcinoma
3. D’Elia C, Trenti E, Krause P, et al. Ther Adv Urol 2022;doi: 10.1177/17562872221090320. PubMed
4. Pycha S, Trenti E, Mian C, et al. World J Urol 2023;41:1323-8. PubMed