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The following is a summary of “Upper TRACT Endometry Score: Development and Internal Validation of an Objective Measure of Variables That Affect Endoscopic Procedures for Upper Tract Urothelial Carcinoma,” published in the April 2025 issue of Journal of Urology by Lange et al. 

Endoscopic management (EM) is a viable option for upper tract urothelial carcinoma (UTUC), but feasibility depends on multiple variables. 

Researchers conducted a retrospective study to identify tumor characteristics affecting EM of UTUC and develop a consensus-based assessment score using expert forecasting. 

They used a modified Delphi method with two survey rounds to develop a scale and identify five consensus categories for the Upper TRACT Endometry Score. Validation used an institutional UTUC database, including patients with low-grade or high-grade UTUC undergoing EM. The score was calculated based on variables at initial ureteroscopy and analyzed using multivariable ordinal logistic regression and exact tests. 

The results showed that 30 experts participated in the surveys. Validation included 110 renal units from 102 patients. Multivariable ordinal logistic regression showed that a higher Upper TRACT Endometry Score increased the likelihood of intensive intervention. Fisher exact test confirmed a significant association with procedures received (P = .004). 

Investigators found the Upper TRACT Endometry Score to be a straightforward tool that, with further validation, could help counsel patients and standardize reporting of variables affecting EM of UTUC. 

Source: auajournals.org/doi/10.1097/JU.0000000000004383