MP66-10 A GENETIC EXPLORATION OF CYSTECTOMY PATIENTS WITH PRIOR PELVIC RADIATION

Abstract

You have accessJournal of UrologyBladder Cancer: Basic Research & Pathophysiology III (MP66)1 Sep 2021MP66-10 A GENETIC EXPLORATION OF CYSTECTOMY PATIENTS WITH PRIOR PELVIC RADIATION Daniel Ranti, John Pfail, Shoshana Rosenzweig, Nikhil Waingankar, John Sfakianos, Peter Wiklund, and Reza Mehrazin Daniel RantiDaniel Ranti More articles by this author , John PfailJohn Pfail More articles by this author , Shoshana RosenzweigShoshana Rosenzweig More articles by this author , Nikhil WaingankarNikhil Waingankar More articles by this author , John SfakianosJohn Sfakianos More articles by this author , Peter WiklundPeter Wiklund More articles by this author , and Reza MehrazinReza Mehrazin More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002106.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prior radiation is an oncogenic risk, and is known to cause radiation-induced bladder cancer. Additionally, radiation dose is a well-established factor in mutation burden. While studies exist correlating outcomes in muscle-invasive disease (MIBC) to prior radiation, there is a lack of data on the genetics of bladder cancer associated with prior radiation. We sought to investigate the genetic impact of radiation in bladder cancer patients METHODS: Data were gathered from a prospectively maintained single-institution cystectomy database. A 161 gene panel identified mutation type, area, and quantity. Mutational burden was calculated by net mutational sum; known oncogenic burden was calculated by adding causal mutations from the Sanger Cancer database. Group comparisons between the two cohorts were performed with the Kruskal-Wallis test (due to lack of normality) for continuous variables, and Fisher’s exact test for categorical comparisons. Kaplan-Meier curves were calculated for survival differences between cohorts. RESULTS: Data from 295 cystectomy patients, 242 without and 52 with prior pelvic radiation, were reviewed. Of these patients, 134 without and 27 with prior radiation had genetic data. Patients with prior radiation were statistically older, had higher Charlson comorbidity scores, lower estimated blood loss, and shorter operative times. Patients with prior radiation had higher rates of muscle invasive disease, discharge to non-home, American Society of Anesthesiologist score, ileal conduit creation, open surgery, and smoking history as compared to patients without prior radiation. No survival differences were seen between the two cohorts. MYC mutations were significantly higher in the radiation group (11.1 vs. 1.5%, p = 0.034). Mutational burdens were not significant between the groups. CONCLUSIONS: No studies have yet been performed investigating the genetic impact of prior radiation in bladder cancer. The higher rate of MYC mutations in patients with prior pelvic radiation is interesting in light of MYC’s role in inhibiting urothelial carcinoma progression. This coincides with our finding that patients with prior radiation also had a higher rate of MIBC. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1133-e1133 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Daniel Ranti More articles by this author John Pfail More articles by this author Shoshana Rosenzweig More articles by this author Nikhil Waingankar More articles by this author John Sfakianos More articles by this author Peter Wiklund More articles by this author Reza Mehrazin More articles by this author Expand All Advertisement Loading ...