PD42-03 ONCOLOGIC SURVEILLANCE INTENSITY FOR VARIANT HISTOLOGY VERSUS PURE UROTHELIAL CARCINOMA OF THE BLADDER AFTER RADICAL CYSTECTOMY

Abstract

You have accessJournal of UrologyCME1 May 2022PD42-03 ONCOLOGIC SURVEILLANCE INTENSITY FOR VARIANT HISTOLOGY VERSUS PURE UROTHELIAL CARCINOMA OF THE BLADDER AFTER RADICAL CYSTECTOMY Alberto Martini, Riccardo Leni, Giuseppe Basile, Simone Scuderi, Mario De Angelis, Luigi Nocera, Giuseppe Rosiello, Giorgio Gandaglia, Chiara Lonati, Luca Afferi, Vincenzo Mirone, Andrea Gallina, Francesco Montorsi, Alberto Briganti, and Marco Moschini Alberto MartiniAlberto Martini More articles by this author , Riccardo LeniRiccardo Leni More articles by this author , Giuseppe BasileGiuseppe Basile More articles by this author , Simone ScuderiSimone Scuderi More articles by this author , Mario De AngelisMario De Angelis More articles by this author , Luigi NoceraLuigi Nocera More articles by this author , Giuseppe RosielloGiuseppe Rosiello More articles by this author , Giorgio GandagliaGiorgio Gandaglia More articles by this author , Chiara LonatiChiara Lonati More articles by this author , Luca AfferiLuca Afferi More articles by this author , Vincenzo MironeVincenzo Mirone More articles by this author , Andrea GallinaAndrea Gallina More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , Alberto BrigantiAlberto Briganti More articles by this author , and Marco MoschiniMarco Moschini More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002603.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is paucity of data to justify the current follow-up schemes after radical cystectomy (RC) suggested from present guidelines and presently, major guidelines do not provide specific recommendations on oncologic surveillance for patients who harbor variant histology bladder cancer (VH BCa) at radical cystectomy, which is known to be associated with higher recurrence risk after radical treatment compared to pure urothelial carcinoma (pUC). On these premises to evaluate whether the EAU surveillance scheme after radical cystectomy is applicable to patients who harbor VH BCa. METHODS: Within a multi-institutional registry, 528 and 1,894 patients with VH BCa and pUC, were identified form a multi-institutional database. Patients were followed up in compliance with the EAU guidelines which entail cross-sectional imaging biannually till the 3rd year and annually thereafter. The non-cumulative incidence of recurrence over time was evaluated through the LOWESS method. RESULTS: Median follow-up of 6.5 years. Among patients with pUC, 628 patients experienced a BCa-related recurrence, among individuals with VH BCa, 207 patients experienced a BCa-related recurrence. The VH cancers were as follows: 48 (9%) non-urothelial variants, 52 (10%) mixed variants, 155 (29%) squamous variant, 74 (14%) micropapillary variant, 152 (29%) had other urothelial variants, and 47 (9%) no residual disease on final pathology Overall, individuals with VH had a higher risk of recurrence (recurrence-free survival: 30% vs 51% at 10-year, p<0.001) and shorter median time to recurrence (88 vs 123 months, p<0.01) relative to pUC. Figure 1 displays the non-cumulative incidence of recurrence after RC. Vertical lines correspond to the time points where imaging should be obtained. Overall, the non-cumulative risk of recurrence was always higher for VH BCa. CONCLUSIONS: Our study confirms that VH BCa is associated with greater recurrence risk than pUC. A follow-up scheme that is valid for pUC should not be applied to individuals with VH. Patients should be counseled for a more intense surveillance scheme if they are found to harbor VH BCa relatively to individuals with pUC. Source of Funding: no © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e695 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alberto Martini More articles by this author Riccardo Leni More articles by this author Giuseppe Basile More articles by this author Simone Scuderi More articles by this author Mario De Angelis More articles by this author Luigi Nocera More articles by this author Giuseppe Rosiello More articles by this author Giorgio Gandaglia More articles by this author Chiara Lonati More articles by this author Luca Afferi More articles by this author Vincenzo Mirone More articles by this author Andrea Gallina More articles by this author Francesco Montorsi More articles by this author Alberto Briganti More articles by this author Marco Moschini More articles by this author Expand All Advertisement PDF DownloadLoading ...