MP08-02 RISK SCORE-BASED SUBSTRATIFICATION IMPROVES SURVEILLANCE COSTS AFTER TRANSURETHRAL RESECTION OF BLADDER TUMOR IN PATIENTS WITH HIGH-RISK NON-MUSCLE-INVASIVE BLADDER CANCER

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP08-02 RISK SCORE-BASED SUBSTRATIFICATION IMPROVES SURVEILLANCE COSTS AFTER TRANSURETHRAL RESECTION OF BLADDER TUMOR IN PATIENTS WITH HIGH-RISK NON-MUSCLE-INVASIVE BLADDER CANCER Naoki Fujita, Shingo Hatakeyama, Masaki Momota, Teppei Okamoto, Hayato Yamamoto, Hiroyuki Ito, Takahiro Yoneyama, Yasuhiro Hashimoto, Kazuaki Yoshikawa, and Chikara Ohyama Naoki FujitaNaoki Fujita More articles by this author , Shingo HatakeyamaShingo Hatakeyama More articles by this author , Masaki MomotaMasaki Momota More articles by this author , Teppei OkamotoTeppei Okamoto More articles by this author , Hayato YamamotoHayato Yamamoto More articles by this author , Hiroyuki ItoHiroyuki Ito More articles by this author , Takahiro YoneyamaTakahiro Yoneyama More articles by this author , Yasuhiro HashimotoYasuhiro Hashimoto More articles by this author , Kazuaki YoshikawaKazuaki Yoshikawa More articles by this author , and Chikara OhyamaChikara Ohyama More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003223.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The aim of the present study was to develop optimized surveillance protocols based on the risk score-based substratifications to improve surveillance costs. METHODS: We retrospectively evaluated 428 patients with high-risk NMIBC who underwent TURBT from November 1993 to April 2019. Independent risk factors for intravesical and upper urinary tract (UUT) recurrences were assessed by multivariable analyses. Patients were substratified into intra-lower, intra-intermediate, and intra-higher groups or UUT-lower, UUT-intermediate, and UUT-higher groups by summing each of the independent risk factors of intravesical and UUT recurrences, respectively. Optimized surveillance protocols to enhance cost-effectiveness were developed using real incidences of recurrence after TURBT. The 10-year total surveillance costs were compared between the European Association of Urology (EAU) guidelines-based and optimized surveillance protocols. RESULTS: Median age and follow-up periods were 72 years and 54 months, respectively. Multivariable analyses showed that chronic kidney disease, tumor size ≥30 mm, and grade 3 were independently associated with intravesical and/or UUT recurrences. Patients were substratified into intra-lower (0 score), intra-intermediate (1 score), and intra-higher (2 or 3 scores) groups for the intravesical recurrence risk estimation or into UUT-lower (0 score), UUT-intermediate (1 score), and UUT-higher (2 scores) groups for the UUT recurrence risk estimation (Figure A). The Kaplan–Meier curves of intravesical and UUT RFS could be clearly separated among the three groups (Figure B and C). Optimized surveillance protocols (Table) promoted a 43% reduction in the 10-year total surveillance cost compared with the EAU guidelines-based surveillance protocol (Figure D). CONCLUSIONS: Optimized surveillance protocols based on risk score-based substratifications could potentially improve surveillance costs after TURBT in patients with high-risk NMIBC. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e93 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Naoki Fujita More articles by this author Shingo Hatakeyama More articles by this author Masaki Momota More articles by this author Teppei Okamoto More articles by this author Hayato Yamamoto More articles by this author Hiroyuki Ito More articles by this author Takahiro Yoneyama More articles by this author Yasuhiro Hashimoto More articles by this author Kazuaki Yoshikawa More articles by this author Chikara Ohyama More articles by this author Expand All Advertisement PDF downloadLoading ...