Mp56-15 development and outcomes of upper tract urothelial carcinoma following trimodality therapy for muscle invasive bladder cancer

You have accessJournal of UrologyCME1 Apr 2023MP56-15 DEVELOPMENT AND OUTCOMES OF UPPER TRACT UROTHELIAL CARCINOMA FOLLOWING TRIMODALITY THERAPY FOR MUSCLE INVASIVE BLADDER CANCER Jillian Egan, Affan Zafar, Linda Nguyen, Matthew Wszolek, Niall Heney, Dimitar Zlatev, Richard Lee, Jason Efstathiou, and Adam Feldman Jillian EganJillian Egan More articles by this author , Affan ZafarAffan Zafar More articles by this author , Linda NguyenLinda Nguyen More articles by this author , Matthew WszolekMatthew Wszolek More articles by this author , Niall HeneyNiall Heney More articles by this author , Dimitar ZlatevDimitar Zlatev More articles by this author , Richard LeeRichard Lee More articles by this author , Jason EfstathiouJason Efstathiou More articles by this author , and Adam FeldmanAdam Feldman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003309.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Trimodality therapy (TMT) for muscle invasive bladder cancer (MIBC) is widely accepted as an alternative to radical cystectomy, as reflected by its inclusion in national guidelines.1,2 However, the development and outcomes of upper tract urothelial carcinoma (UTUC) after TMT have not been described in a contemporary cohort. METHODS: Our IRB approved, institutional database was retrospectively reviewed for all patients who underwent TMT for MIBC from 2000-2017. Upper tract recurrence was defined as detection of UTUC after the completion of TMT. Pathologic and follow-up data were recorded from review of the original pathology and clinical reports. Descriptive statistics were calculated, and Kaplan Meier time-to-event analysis was performed using STATA 17.0. RESULTS: 271 patients were included. Median follow up was 51.8 [interquartile range (IQR) 18.0-98.1] months (mo). 7 patients (2.6%) experienced upper tract recurrence at a median time of 46 [5-49] mo. Median upper tract recurrence free survival was not reached. There was one high grade (grade 3/3), two grade 2/3, and two low grade (Grade 1-2/3) tumors detected. 2 patients did not have pathology available. 2 patients were treated with nephroureterectomy, 3 were managed endoscopically and 2 received no treatment (1 due to comorbidities and 1 refused treatment). For those treated with nephroureterectomy, pathologic grade and stage were grade 2 pTaNx and grade 3 pT2Nx. Both had associated carcinoma in situ. Neither suffered complications. Of those who developed UTUC after TMT, 3 had ureteral stents placed for tumor or resection near or surrounding the ureteral orifice and no patients had hydronephrosis at the time of TMT for their bladder cancer. CONCLUSIONS: Upper tract recurrence after TMT is relatively rare, occurring in 2.6% of patients, consistent with prior data on upper tract recurrence following cystectomy for MIBC.3 The management of UTUC patients after TMT can proceed according to the standard of care for UTUC with no increased risk of complications or poorer outcomes. Source of Funding: None. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e780 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jillian Egan More articles by this author Affan Zafar More articles by this author Linda Nguyen More articles by this author Matthew Wszolek More articles by this author Niall Heney More articles by this author Dimitar Zlatev More articles by this author Richard Lee More articles by this author Jason Efstathiou More articles by this author Adam Feldman More articles by this author Expand All Advertisement PDF downloadLoading ...