692 UPPER TRACT IMAGING SURVEILLANCE IN PATIENTS WITH NON-MUSCLE INVASIVE BLADDER

Abstract

You have accessJournal of UrologyUrothelial Cancer: upper Tract Tumors (I)1 Apr 2013692 UPPER TRACT IMAGING SURVEILLANCE IN PATIENTS WITH NON-MUSCLE INVASIVE BLADDER Itay Sternberg, Gal Keren Paz, Ling Chen, Harry Herr, Sherri Donast, Bernard Bochner, and Guido Dalbagni Itay SternbergItay Sternberg New York, NY More articles by this author , Gal Keren PazGal Keren Paz New York, NY More articles by this author , Ling ChenLing Chen New York, NY More articles by this author , Harry HerrHarry Herr New York, NY More articles by this author , Sherri DonastSherri Donast New York, NY More articles by this author , Bernard BochnerBernard Bochner New York, NY More articles by this author , and Guido DalbagniGuido Dalbagni New York, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.248AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Patients with non-muscle invasive bladder cancer (NMIBC) undergo routine upper tract imaging. This holds the hazard of exposure to contrast medium and radiation. Our aim is to report the risk of UT-TCC among patients followed for NMIBC and to explore the role of routine upper tract imaging in these diagnoses. METHODS Kaplan-Meier curves were calculated to determine the difference in UT-TCC free probability between different bladder cancer stages. Stage was included as a time dependent covariate. Follow-up time was calculated from the time of diagnosis of the first bladder tumor. Descriptive statistics were used to report on rates of imaging studies. RESULTS During the study period 996 patients were referred for treatment of NMIBC to our institute. At last follow up 51 patients developed an UT-TCC. The median follow up time in patients without diagnosis of UT-TCC was 5.5 years. Figure 1 presents the Kaplan-Meier estimates for UT-TCC free probability stratified by stage. The 5 year UT-TCC free probability among Ta and T1 patients was 97% (95%CI 94%, 98%) and 94% (95%CI 90%, 96%), respectively. The 10 year UT-TCC free probability among Ta and T1 patients was 94% (95%CI 89%, 96%) and 89% (95%CI 83%, 93%), respectively. Of 51 patients diagnosed with UT-TCC, 30 (59%) were diagnosed after developing symptoms, 15 (29%) were diagnosed on routine imaging and 6 (12%) were unknown. Four of 15 (27%) of patients with UT-TCCs diagnosed on routine imaging had hydronephrosis, thus sonography would have raised the need for further evaluation. Two patients diagnosed on routine imaging without hydronephrosis had invasive UT-TCC (one patient with T1 and another with T2). Twenty one percent of patients underwent more than 5 imaging scans after diagnosis of bladder cancer, 3% underwent more than 10 imaging scans, and 1% underwent more than 15 scans. At last follow up, 3333 routine imaging were conducted. CONCLUSIONS Upper tract surveillance in patients with NMIBC can be achieved with sonography and surveillance of symptoms. Upper tract evaluation with CT or endoscopy is warranted in patients with symptoms suggestive of UT-TCC or sonographic hydronephrosis. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e284 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Itay Sternberg New York, NY More articles by this author Gal Keren Paz New York, NY More articles by this author Ling Chen New York, NY More articles by this author Harry Herr New York, NY More articles by this author Sherri Donast New York, NY More articles by this author Bernard Bochner New York, NY More articles by this author Guido Dalbagni New York, NY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...