MP55-16 SKELETAL-RELATED EVENTS IN PATIENTS WITH BONE-METASTATIC CARCINOMA OF THE BLADDER OR UPPER URINARY TRACT

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive II (MP55)1 Apr 2020MP55-16 SKELETAL-RELATED EVENTS IN PATIENTS WITH BONE-METASTATIC CARCINOMA OF THE BLADDER OR UPPER URINARY TRACT Nima Almassi*, Imaani Easthausen, Soleen Ghafoor, Paul Christos, Timothy Donahue, Jonathan Rosenberg, and Azeez Farooki Nima Almassi*Nima Almassi* More articles by this author , Imaani EasthausenImaani Easthausen More articles by this author , Soleen GhafoorSoleen Ghafoor More articles by this author , Paul ChristosPaul Christos More articles by this author , Timothy DonahueTimothy Donahue More articles by this author , Jonathan RosenbergJonathan Rosenberg More articles by this author , and Azeez FarookiAzeez Farooki More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000924.016AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Bone metastases are common in patients with advanced bladder or upper urinary tract cancer. The morbidity of bone metastasis can be quantified using the composite endpoint skeletal related event (SRE), however data are limited on the morbidity of bone metastases in this patient population. The objective of this study was to measure SRE-free survival in patients with bone-metastatic bladder cancer or UTUC, identify clinicopathologic characteristics associated with the development of SREs, and assess use of antiresorptive therapy in patients with bone metastases. METHODS: Under an institutional review board-approved protocol, we identified 328 patients with bone-metastatic bladder or upper urinary tract cancer managed at Memorial Sloan Kettering between 2000 and 2018. SREs were defined as presence of spinal cord compression from bone metastasis, pathologic fracture, treatment of bone metastasis with radiotherapy or surgery, or hypercalcemia of malignancy. SRE-free survival from the time of bone metastasis diagnosis was estimated using Kaplan-Meier analysis. Predictors of SRE were identified using competing-risks regression analysis. RESULTS: Of 328 patients with bone-metastatic disease, 198 (60%) developed ≥1 SRE, including 84 (26%) with multiple SREs. Two-hundred sixty four patients (80%) had non-metastatic disease at diagnosis. At the time of bone metastasis diagnosis, the most commonly involved sites were the vertebrae (n=216; 66%), pelvis (n=202; 62%), and nonvertebral thoracic bones (n=73; 22%). The most common SREs were bone radiotherapy (n=165; 83%), pathologic fracture (n=73; 37%), and orthopedic surgery (n=39; 20%). Median SRE-free survival from time of bone metastasis diagnosis was 7.4 months. One hundred eighteen patients (36%) received antiresorptive therapy. On competing-risks regression analysis, history of radical cystectomy (hazard ratio [HR], 1.40; 95% CI, 1.05-1.86; P=0.02) and hip involvement at the time of bone metastasis diagnosis (HR, 1.65; 95% CI, 1.12-2.42; P=0.01) were independently associated with risk of SRE. CONCLUSIONS: SREs are common among patients with bone-metastatic cancer of the bladder or upper urinary tract and typically occur soon after the development of bone metastasis. Patients with a history of radical cystectomy or with hip involvement at the time of bone metastasis diagnosis have a higher risk of SRE. Use of antiresorptive therapy in these patients should be considered. Additional studies are needed to identify interventions to further reduce skeletal morbidity in patients with bone metastasis. Source of Funding: This work was supported by the Sidney Kimmel Center for Prostate and Urologic Cancers and by National Institutes of Health/National Cancer Institute Cancer Center Support Grant P30 CA008748. N.A. was supported by National Institutes of Health T32 Ruth L. Kirschstein Institutional National Research Service Award. I.J.E. and P.J.C. were partially supported by National Institutes of Health 1-UL1-TR002384-01 from the Clinical and Translational Science Center at Weill Cornell Medicine. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e844-e844 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nima Almassi* More articles by this author Imaani Easthausen More articles by this author Soleen Ghafoor More articles by this author Paul Christos More articles by this author Timothy Donahue More articles by this author Jonathan Rosenberg More articles by this author Azeez Farooki More articles by this author Expand All Advertisement PDF downloadLoading ...