Re: Tatsushi Kawada, Ekaterina Laukhtina, Fahad Quhal, et al. Oncologic and Safety Outcomes for Endoscopic Surgery Versus Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: An Updated Systematic Review and Meta-analysis. Eur Urol Focus 2023;9:236–40

We read with great interest the systematic review and meta-analysis by Kawada et al [ [1] Kawada T. Laukhtina E. Quhal F. et al. Oncologic and safety outcomes for endoscopic surgery versus radical nephroureterectomy for upper tract urothelial carcinoma: an updated systematic review and meta-analysis. Eur Urol Focus. 2023; 9: 236-240https://doi.org/10.1016/j.euf.2022.11.016 Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar ]. The authors undertook an exceptional endeavour to compare the efficacy of endoscopic management (EM) with radical nephroureterectomy (RNU) in patients diagnosed with upper tract urothelial carcinoma (UTUC). Their study findings reveal that for low-grade UTUC, EM yields comparable survival outcomes to RNU. However, EM is associated with higher rates of local recurrence, necessitating long-term and rigorous surveillance as well as repeated interventions. We are grateful to the authors for their remarkable work. However, it is important to acknowledge that this study has some limitations that should not be ignored.