Volume 22, Number 1Review ArticlesManagement of Low-grade Upper Tract Urothelial Carcinoma: An Unmet NeedManagement ReviewNeal D ShoreJay RamanUpper tract urothelial cancers (UTUC) are frequently managed by radical nephroureterectomy (RNU), a major operative procedure that may entail short-term morbidity and long-term decline in renal function. Kidney-sparing procedures offer a less invasive alternative to RNU for low-risk, low-grade UTUC (LG-UTUC). They are associated with similar disease-specific survival rates and better long-term renal function, albeit with a potentially increased risk of recurrence. Strategies to decrease LG-UTUC recurrence include improved risk stratification and enhanced endoscopic instrumentation. Chemoablation may represent an alternative, innovative kidney-sparing approach for LG-UTUC. [Rev Urol. 2020;22(1):1–8] © 2020 MedReviews®, LLCRisk stratificationUpper tract urothelial cancerRadical nephroureterectomyNephron-sparing procedureLow-grade tumors