Tumor diameter and stage are independent risk factors for intravesical recurrence of organ-confined upper tract urothelial carcinoma (UTUC) following radical nephroureterectomy (RNU), according to a new study.
In a retrospective study of patients with organ-confined UTUC who underwent RNU combined with bladder cuff resection, investigators propensity score matched 42 patients who experienced intravesical recurrence (IVR) with 162 who did not. After adjusting for multiple variables, tumor diameter larger than 2 cm was significantly associated with a nearly 2.7-fold increased risk of IVR compared with a diameter of 2 cm or less, Yunzhong Jiang, MD, and colleagues at ShengJing Hospial of China Medical University in Shenyang, China, reported in the International Journal of Surgery. Compared with T1 tumors, T2 and T3 tumors were significantly associated with 2.8- and 3.4-fold increased risks of IVR, respectively.
In addition, the study found that patients who had IVR had significantly worse 3-year cancer-specific and overall survival compared with the non-IVR group (45.8% vs 84.9% and 45.8% and 80.0%, respectively).
The investigators concluded that “more active postoperative surveillance and treatment strategies should be adopted for these patients, which may help improve treatment outcomes.”
The IVR and non-IVR groups had mean ages of 65.1 and 66.4 years, respectively, and follow-up times of 49.0 and 38.5 months, respectively. IVR developed after a median follow-up period of 41 months.
Jiang Y, Yao Z, Zhu X, et al. Risk factors and oncological outcomes for intravesical recurrence in organ-confined upper urinary tract urothelial carcinoma patients after radical nephroureterectomy: A propensity-score matched case control study [published online February 17, 2020]. Int J Surg. 2020;76:28-34. doi: 10.1016/j.ijsu.2020.02.015