(UroToday.com) At the European Multidisciplinary Congress on Urological Cancers 2020 virtual meeting, Dr. Shahrokh Shariat discussed the role of kidney sparing surgery for upper tract urothelial carcinoma. Dr. Shariat notes that radical nephroureterectomy is not the standard of care for all patients with upper tract urothelial carcinoma, in particular those with low-grade Ta tumors, as it has been estimated that 18-25% of patients may be over-treated (pT0, pTa, pTis) with radical nephroureterectomy. Another reason to avoid over-treatment is the risk of chronic kidney disease, which is common in the population of patients with upper tract urothelial carcinoma. Indeed, prior to radical nephroureterectomy, ~50% of patients have an eGFR < 60 ml/min/1.73m2 and after surgery this increases to >75% with have an eGFR < 60 ml/min/1.73m2.