MP48-14 UTUC SURVEILLANCE FOLLOWING BCG-TREATED NMIBC: TIMING AND RISK FACTORS ASSOCIATED WITH RECURRENCE

Abstract

You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma II (MP48)1 Sep 2021MP48-14 UTUC SURVEILLANCE FOLLOWING BCG-TREATED NMIBC: TIMING AND RISK FACTORS ASSOCIATED WITH RECURRENCE Kelly Bree, Patrick Hensley, Nathan Brooks, Supriya Nagaraju, Neema Navai, Colin Dinney, Surena Matin, and Ashish Kamat Kelly BreeKelly Bree More articles by this author , Patrick HensleyPatrick Hensley More articles by this author , Nathan BrooksNathan Brooks More articles by this author , Supriya NagarajuSupriya Nagaraju More articles by this author , Neema NavaiNeema Navai More articles by this author , Colin DinneyColin Dinney More articles by this author , Surena MatinSurena Matin More articles by this author , and Ashish KamatAshish Kamat More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002074.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Following a diagnosis of non-muscle invasive bladder cancer (NMIBC), patients are at risk for developing upper tract urothelial carcinoma (UTUC). Guidelines vary on the frequency of upper tract imaging during surveillance from yearly (EAU) to every 1-2 years (AUA/SUO) but this is based on admittedly ‘weak evidence’ or ‘expert opinion’ due to a paucity of data. Herein, we sought to characterize the timing of UTUC following NMIBC diagnosis, as well as to identify risk factors for UTUC which could inform future screening recommendations. METHODS: An IRB approved review of patients with NMIBC who received adequate induction BCG, as defined by the US FDA, at our institution from 2000-2018 was performed. Patients were stratified by development of metachronous UTUC (any time after NMIBC diagnosis). Patients with UTUC prior to or synchronous with NMIBC diagnosis were excluded. RESULTS: Of 537 patients with NMIBC who received induction BCG, 22 (4.1%) developed metachronous UTUC. Factors associated with the development of UTUC included pure Tis (22.7% vs. 5.0%, p=0.002) and multifocal disease (86.4% vs. 50.1%, p=0.0009). Notably, bladder tumor grade and size were not associated with UTUC recurrence (p=0.569 and p=1.00, respectively). UTUC onset occurred within 5 years in the majority of patients (86.4%, 19/22), however, one patient did develop UTUC more than 10 years after initial NMIBC diagnosis. Rates of radical cystectomy (45.5% vs. 14.0%, p=<0.001) and urothelial cancer-specific mortality (27.3% vs. 4.1%, p<0.001) were higher in patients with metachronous UTUC. CONCLUSIONS: UTUC occurs within the first five years following NMIBC diagnosis in the overwhelming majority of patients, however, late recurrences (>10 years) were noted. The presence of Tis and multifocal NMIBC are associated with increased risk of UTUC and screening efforts may be focused on this subgroup of patients. Source of Funding: This research was supported by the Wayne B. Duddlesten Professorship in Cancer Research and the Raymond and Maria Floyd Bladder Cancer Research Foundation Grant © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e870-e870 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kelly Bree More articles by this author Patrick Hensley More articles by this author Nathan Brooks More articles by this author Supriya Nagaraju More articles by this author Neema Navai More articles by this author Colin Dinney More articles by this author Surena Matin More articles by this author Ashish Kamat More articles by this author Expand All Advertisement Loading ...