Current smoking and large multifocal tumors in patients undergoing radical nephroureterectomy (RNU) for low-grade upper tract urothelial carcinoma (LG-UTUC) are at higher risk for bladder recurrence, according to study findings presented at the 22nd annual meeting of the Society of Urologic Oncology.
Follow-up cystoscopy may be warranted at 3 and 6 months after RNU for patients with these risk factors, Heather L. Huelster, MD, of the Moffitt Cancer Center in Tampa, Florida, said in an oral presentation.
“Patients without those risk factors may be able to undergo cystoscopy annually,” she said.
The study included a retrospective electronic medical record review of 214 RNUs performed at the Moffitt Cancer Center. Of these, 37 patients had LG-UTUC on final pathology. The study population had a mean age of 71.9 years and was 74.8% male and 89.2% White.
Patients with LG-UTUC had median overall, recurrence-free, and cancer-specific survival times of 91.3, 12.7, and 114.5 months, respectively, according to the investigators. Metastasis developed in 1 patient who died 36 months after RNU.
Any recurrence of urothelial carcinoma developed in 20 patients (54.1%) during a mean follow-up of 43.5 months. All recurrences occurred in the bladder. Recurrence was diagnosed at a median 6.0 months after RNU. Early recurrence, defined as occurring within 6 months of RNU, developed in 9 patients (24.3%). Increasing tumor size and tumor multifocality were significantly associated with early recurrence of urothelial carcinoma within 6 months of RNU in unadjusted analysis.
On multivariate analysis, current smoking was significantly associated with 10.6-fold increased odds of early recurrence. Each 1 cm increase in tumor size was significantly associated with 1.9-fold increased odds of early recurrence.
Huelster HL, Bilotta A, Russo N, et al. Predictive risk factors for early recurrence after radical nephroureterectomy for low-grade upper tract urothelial carcinoma. Presented at the 22nd annual meeting of the Society of Urologic Oncology, December 1-3, 2021. Poster 117.