MP27-14 LOCATION OF THE TUMOR IN UPPER TRACT UROTHELIAL CARCINOMA (UTUC) IMPACTS ON THE PRESENCE OF CONCOMITANT UROTHELIAL CARCINOMA OF THE BLADDER: A MULTI-INSTITUTIONAL DATABASE STUDY

Abstract

You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma II1 Apr 2016MP27-14 LOCATION OF THE TUMOR IN UPPER TRACT UROTHELIAL CARCINOMA (UTUC) IMPACTS ON THE PRESENCE OF CONCOMITANT UROTHELIAL CARCINOMA OF THE BLADDER: A MULTI-INSTITUTIONAL DATABASE STUDY Teruo Inamoto, Kiyoshi Takahara, Hideyasu Matsuyama, Kiyohide Fujimoto, Hiroaki Shiina, Shigeru Sakano, Kazuhiro Nagao, Makito Miyake, Yoshihiro Tatsumi, Hiroaki Yasumoto, and Haruhito Azuma Teruo InamotoTeruo Inamoto More articles by this author , Kiyoshi TakaharaKiyoshi Takahara More articles by this author , Hideyasu MatsuyamaHideyasu Matsuyama More articles by this author , Kiyohide FujimotoKiyohide Fujimoto More articles by this author , Hiroaki ShiinaHiroaki Shiina More articles by this author , Shigeru SakanoShigeru Sakano More articles by this author , Kazuhiro NagaoKazuhiro Nagao More articles by this author , Makito MiyakeMakito Miyake More articles by this author , Yoshihiro TatsumiYoshihiro Tatsumi More articles by this author , Hiroaki YasumotoHiroaki Yasumoto More articles by this author , and Haruhito AzumaHaruhito Azuma More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1045AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The predictive impact of primary tumor location for patients with upper-tract urothelial carcinoma (UTUC) on the presence of concomitant urothelial carcinoma of the bladder is still contentious. We precisely evaluated the association between tumor location and concomitant presence of urothelial carcinoma of the bladder, along with urothelial recurrence free survival (URFS) in patients with UTUC. METHODS A total of 1349 patients with localized UTUC (Ta-4N0M0) from a retrospective multi-institutional cohort were studied. We queried 4 UTUC databases. Retrospective clinical series on patients with localized UTUC managed by nephroureterectomy (NU) with bladder cuff, for whom data from the Yamaguchi Uro-Oncology Group and 4 tertiary medical centers registries. Patients with a history of chemotherapy were excluded from the study. Associations between the location of the tumor and subsequent outcome following NU were assessed using COX multivariate analysis. Location of the tumor was verified by pathological samples. Urothelial recurrence was defined as tumor relapse in any local urothelium, and coded apart from distant metastasis. The median follow-up was 34 months. RESULTS Six hundred and three patients had pelvic tumors (45.1%), 123 had ureteral tumors in U1 segment (9.2%), 109 in U2 segment (8.1%), and 263 in U3 segment (19.7%). 240 had multifocal tumors (17.80%) as follows; 14 (1.0%) in pelvis and ureter, 14 (1.0%) in U1+U2, 2(0.1%) in U1+U3, 28 (2.1%) in U2+U3, 9 (0.7%) in U1+U2+U3. 173 (12.9%) had solitary ureteral tumors where the distinct location was not described. Of all, 159 (17.5%) had concomitant bladder tumors. Logistic regression analysis which include gender, age, hydronephrosis, cytology, performance status, grade, lymphovascular invasion (LVI), pT, pN, tumor focality, tumor location was associated with the presence of concomitant bladder cancer (p=0.004, HR; 1.265). When the tumor location was stratified into 8 segments, including multifocal tumors, only U3 segment remained as predictive for the presence of concomitant bladder cancer (p=0.002, HR= 2.872). Kaplan-meier analysis for unifocal disease showed that lower ureter tumors (combinatnion of U2 U3) had the worse prognosis for urothelial recurrence than pelvic tumors or upper ureteral tumors (U1) (p=0.019 for lower ureteral tumors vs. pelvic tumors, p=0.132 for upper ureteral tumor vs. pelvic tumor by log rank). Multivariate analysis showed that lower ureter location remained as a prognostic factor for urothelial recurrence after adjusting for gender, age, hydronephrosis, urine cytology, LVI, pT, and pN (p=0.006, HR=1.761), and similar tendency was found when the analysis was run for patients without concomitant bladder tumors (p=0.002, HR=2.244). Lower ureteral tumors had a higher prevalence of disease specific deaths (HR=2.224) with reference to upper ureter tumors and pelvic tumors. CONCLUSIONS This multi-institutional study showed the primary tumor locations were independently associated with the presence of concomitant bladder tumors and subsequent urothelial recurrence. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e368 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Teruo Inamoto More articles by this author Kiyoshi Takahara More articles by this author Hideyasu Matsuyama More articles by this author Kiyohide Fujimoto More articles by this author Hiroaki Shiina More articles by this author Shigeru Sakano More articles by this author Kazuhiro Nagao More articles by this author Makito Miyake More articles by this author Yoshihiro Tatsumi More articles by this author Hiroaki Yasumoto More articles by this author Haruhito Azuma More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...