Low biopsy volume in ureteroscopy does not affect tumor biopsy grading in upper tract urothelial carcinoma

European Association of Urology Guidelines on Upper Urinary Tract Urothelial Cell Carcinoma: 2015 Update

“…Such ureteroscopic biopsies can determine tumour grade in 90% of cases with a low false-negative rate, regardless of sample size [28]. Undergrading may occur following diagnostic biopsy, making intensive follow-up necessary if renal-sparing treatment is selected [1].…”

Ureterorenoscopy for Upper Tract Urothelial Carcinoma: How Often Are We Missing Lesions?

“…6,7 The ability to both visualize lesions and perform biopsies has greatly improved diagnostic accuracy and prognosis determination. [7][8][9][10] Tumor grading using URS with biopsy is accurate in about 90% of cases. [8][9][10] Accurately determining the stage of UTUCs has proved more difficult, with about 45% of papillary tumors upstaged on final pathology after definitive resection.…”

Diagnostic ureteroscopy for upper tract urothelial carcinoma is independently associated with intravesical recurrence after radical nephroureterectomy

“…With the development of medical devices, diagnostic ureteroscopy is becoming a powerful tool for patients with UTUC, and it is used to visualize and biopsy the entire upper urinary tract with a technical success approaching 95% (23). Coupled with biopsies, it provides satisfactory diagnostic accuracy (24).…”