MP48-15 HOW LONG SHOULD YOU WAIT IN-BETWEEN FOLLOW-UP URETEROSCOPIES DURING CONSERVATIVE MANAGEMENT OF UPPER-TRACT UROTHELIAL CARCINOMA?

Abstract

You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma II (MP48)1 Sep 2021MP48-15 HOW LONG SHOULD YOU WAIT IN-BETWEEN FOLLOW-UP URETEROSCOPIES DURING CONSERVATIVE MANAGEMENT OF UPPER-TRACT UROTHELIAL CARCINOMA? Eugenio Ventimiglia, Luca Villa, Christian Corsini, Pietro Dioni, Costantino Abbate, Olivier Traxer, Emanuele Montanari, Francesco Montorsi, and Andrea Salonia Eugenio VentimigliaEugenio Ventimiglia More articles by this author , Luca VillaLuca Villa More articles by this author , Christian CorsiniChristian Corsini More articles by this author , Pietro DioniPietro Dioni More articles by this author , Costantino AbbateCostantino Abbate More articles by this author , Olivier TraxerOlivier Traxer More articles by this author , Emanuele MontanariEmanuele Montanari More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Andrea SaloniaAndrea Salonia More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002074.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: It is not clear what should be the proper endoscopic follow-up strategy in patients with UTUC managed conservatively, especially in terms of timing between two consecutive flexible ureteroscopies (fURS). We aimed at the determining the best follow-up strategy, defined as the one which minimize the risk of cancer progression. METHODS: Data from 140 consecutive fURS performed for UTUC at a single academic center between 2015 and 2020 were included. fURS were performed using a digital flexible ureterorenoscope (Flex XC, Karl-Storz). Tumor Ho:YAG laser ablation was performed in any case whenever feasible (VersaPulse PowerSuite 100W, Lumenis). Patients with high grade UTUC at initial diagnostic biopsy and managed conservatively due to imperative indications were included in the analysis. For each patient, we estimated the average interval between two consecutive fURS procedures (fURSint) until last follow-up date. Multivariable Cox regression analysis estimated the association between fURSint and risk of cancer progression, accounting for patient age, tumor size and grade. We analysed the graphical association (LOWESS) between fURSint and the multivariable adjusted probability of progression-free survival, in order to identify possible non-linear trends for both low- and high-grade UTUC. RESULTS: Median (IQR) patient age and follow-up time were respectively 70 (66-79) years and 14 (6-31) months. Median (IQR) fURSint was 3.4 (2-5.6) months. Disease progression occurred in 11 (31%) patients and was classified as systemic in 4 (11%). At multivariable Cox regression analysis, longer fURSint was associated to reduced progression-free survival (HR [95% CIs] 0.32 [0.19-0.54]). A longer fURSint was more detrimental in men with high-grade UTUC, especially when it was longer than 3 months (Figure 1). CONCLUSIONS: A long fURSint should be avoided in men under endoscopic follow-up for conservative management of UTUC. In men with high-grade UTUC and imperative indications for endoscopic follow-up, fURSint longer than 3 months is associated to poor prognosis. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e870-e871 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Eugenio Ventimiglia More articles by this author Luca Villa More articles by this author Christian Corsini More articles by this author Pietro Dioni More articles by this author Costantino Abbate More articles by this author Olivier Traxer More articles by this author Emanuele Montanari More articles by this author Francesco Montorsi More articles by this author Andrea Salonia More articles by this author Expand All Advertisement Loading ...