Risk factors for intravesical recurrence after radical nephroureterectomy for upper tract urothelial carcinoma: A meta-analysis1These authors equally dedicated to this article.

Abstract Objective To assess the characteristics, predictive risk factors, and prognostic effect of secondary bladder cancer (BCa) following radical nephroureterectomy (RNU) in upper tract urothelial carcinoma (UTUC). Methods Using the Surveillance, Epidemiology, and End Results (SEER) database, the authors analyzed clinicopathologic characteristics and survival data from 472 UTUC patients with secondary BCa after RNU between 2004 and 2017. Cox’s proportional hazard regression model was implemented to identify independent predictors associated with post-recurrence outcomes. The threshold for statistical significance was p < 0.05. Results In total, 200 Ta-3N0M0 localized UTUC patients with complete data were finally included. With a median follow-up of 71 months (interquartile ranges [IQR] 36 -103.75 months), 52.5% (n = 105) had died, with 30.5% (n = 61) dying of UTUC. The median time interval from UTUC to BCa was 13.5 months (IQR 6–40.75 months). According to multivariable Cox regression analysis, patients with intravesical recurrence (IVR) located at multiple sites, advanced BCa stage, higher BCa grade, elderly age and a shorter recurrence time, encountered worse cancer-specific survival (CSS) (all p ༜0.05). Conclusions For primary UTUC patients experiencing IVR after radical surgery, advanced age, multiple IVR sites, shorter recurrence time, higher BCa stage, and grade proved to be significant independent prognostic factors of CSS. We ought to pay more attention to IVR prevention as well as to earlier signs which may increase the likelihood of early detection. Having the ability to manage what may be seen as the superficial BCa signs may enable us to improve survival but further research is required.

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PD35-08 RISK FACTORS FOR INTRAVESICAL RECURRENCE AFTER RADICAL NEPHROURETERECTOMY FOR UPPER TRACT UROTHELIAL CARCINOMA: A META-ANALYSIS

The Journal of Urology ◽

10.1016/j.juro.2014.02.2421 ◽

2014 ◽

Vol 191 (4S) ◽

Author(s):

Haichao Yuan ◽

Ping Han ◽

Qiang Wei

Keyword(s):

Risk Factors ◽

Urothelial Carcinoma ◽

Meta Analysis ◽

Upper Tract Urothelial Carcinoma ◽

Radical Nephroureterectomy ◽

Upper Tract

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Developing a nomogram for predicting intravesical recurrence after radical nephroureterectomy: a retrospective cohort study of mainland Chinese patients

Japanese Journal of Clinical Oncology ◽

10.1093/jjco/hyab017 ◽

2021 ◽

Author(s):

Shicong Lai ◽

Xingbo Long ◽

Pengjie Wu ◽

Jianyong Liu ◽

Samuel Seery ◽

...

Keyword(s):

Urothelial Carcinoma ◽

Cox Regression ◽

Upper Tract Urothelial Carcinoma ◽

Chinese Patients ◽

Clinicopathological Parameters ◽

Radical Nephroureterectomy ◽

Ki 67 ◽

Data Set ◽

Mainland Chinese ◽

Upper Tract

Abstract Objective To evaluate the role of Ki-67 in predicting subsequent intravesical recurrence following radical nephroureterectomy and to develop a predictive nomogram for upper tract urothelial carcinoma patients. Methods This retrospective analysis involved 489 upper tract urothelial carcinoma patients who underwent radical nephroureterectomy with bladder cuff excision. The data set was randomly split into a training cohort of 293 patients and a validation cohort of 196 patients. Immunohistochemical analysis was used to assess the immunoreactivity of the biomarker Ki-67 in the tumor tissues. A multivariable Cox regression model was utilized to identify independent intravesical recurrence predictors after radical nephroureterectomy before constructing a nomographic model. Predictive accuracy was quantified using time-dependent receiver operating characteristic curve. Decision curve analysis was performed to evaluate the clinical benefit of models. Results With a median follow-up of 54 months, intravesical recurrence developed in 28.2% of this sample (n = 137). Tumor location, multifocality, pathological T stage, surgical approach, bladder cancer history and Ki-67 expression levels were independently associated with intravesical recurrence (all P < 0.05). The full model, which intercalated Ki-67 with traditional clinicopathological parameters, outperformed both the basic model and Xylinas’ model in terms of discriminative capacity (all P < 0.05). Decision-making analysis suggests that the more comprehensive model can also improve patients’ net benefit. Conclusions This new model, which intercalates the Ki-67 biomarker with traditional clinicopathological factors, appears to be more sensitive than nomograms previously tested across mainland Chinese populations. The findings suggest that Ki-67 could be useful for determining risk-stratified surveillance protocols following radical nephroureterectomy and in generating an individualized strategy based around intravesical recurrence predictions.

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