MP48-10 THE ROLE OF PRIOR BLADDER CANCER ON ANY RECURRENCE AND DISTANT METASTASIS IN PATIENTS TREATED WITH RADICAL NEPHROURETERECTOMY

Abstract

You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma II (MP48)1 Sep 2021MP48-10 THE ROLE OF PRIOR BLADDER CANCER ON ANY RECURRENCE AND DISTANT METASTASIS IN PATIENTS TREATED WITH RADICAL NEPHROURETERECTOMY Alberto Martini, Chiara Lonati, Andrea Necchi, Alberto Briganti, Francesco Montorsi, Agostino Mattei, Luca Afferi, Stefania Zamboni, Claudio Simeone, Shahrokh F. Shariat, and Marco Moschini Alberto MartiniAlberto Martini More articles by this author , Chiara LonatiChiara Lonati More articles by this author , Andrea NecchiAndrea Necchi More articles by this author , Alberto BrigantiAlberto Briganti More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , Agostino MatteiAgostino Mattei More articles by this author , Luca AfferiLuca Afferi More articles by this author , Stefania ZamboniStefania Zamboni More articles by this author , Claudio SimeoneClaudio Simeone More articles by this author , Shahrokh F. ShariatShahrokh F. Shariat More articles by this author , and Marco MoschiniMarco Moschini More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002074.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Literature lacks clear evidence regarding the association between history of prior UC and survival outcomes in patients treated with radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). We aimed to investigate the role of prior UC on any recurrence (aR) and distant metastasis (DM) following RNU for low grade (LG) and high grade (HG) UTUC. METHODS: We retrospectively analyzed data of 1583 patients treated with RNU for UTUC at 8 tertiary referral centers between 1992 and 2016. aR was defined as recurrence in the urinary tract, in the resection bed as well the presence of DM, defined as metastatic disease outside the urinary tract and regional lymph nodes. Time to aR and DM were computed from RNU. First, we investigated the role of prior UC on aR and DM. Multivariable Cox models were generated to predict risk of aR and DM according to prior history of UC, distinguished into no prior UC, non-muscle invasive (NMIBC) and muscle invasive bladder cancer (MIBC). Second, we evaluated the effect of prior UC on overall survival (OS) among patients experiencing aR. RESULTS: Median follow-up for survivors was 3.6 years. Overall, 71%, 25% and 4% of patients had no history of prior UC, NMIBC and MIBC, respectively. 5-year aR-free rates were 61%, 41% and 19% in LG UTUC patients (p<0.001) and 42%, 34% and 30% in HG UTUC (p=0.1), respectively in patients with no prior UC, NMIBC and MIBC (Fig. 1A and 1B). 5-year DM-free rates were 92%, 90% and 87% in LG UTUC patients (p>0.05) and 68%, 75% and 45% in HG UTUC patients (p=0.01) according to no prior UC, NMIBC and MIBC, respectively (Fig. 1C and 1D). At multivariable analyses, prior NMIBC was associated to a higher risk of aR among LG (p<0.005) and HG UTUC patients (p=0.04) compared to no prior UC, while prior MIBC correlated to a higher risk of aR in LG UTUC patients. Among patients experiencing aR, 5-years OS after recurrence was 73% vs. 90% (p=0.003) in LG UTUC and 27% vs. 38% (p=0.05) in HG UTUC patients without and with prior UC, respectively. CONCLUSIONS: Patients with a prior history of UC are at a higher risk of experiencing aR after RNU for both LG and HG UTUC. Our study provides important information which could address patient’s counseling and decision-making process. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e867-e867 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alberto Martini More articles by this author Chiara Lonati More articles by this author Andrea Necchi More articles by this author Alberto Briganti More articles by this author Francesco Montorsi More articles by this author Agostino Mattei More articles by this author Luca Afferi More articles by this author Stefania Zamboni More articles by this author Claudio Simeone More articles by this author Shahrokh F. Shariat More articles by this author Marco Moschini More articles by this author Expand All Advertisement Loading ...