Concomitant Bladder Tumor Is a Risk Factor for Bladder Recurrence but Not Upper Tract.

Area of Science:

• Uro-oncology
• Clinical outcomes research
• Surgical oncology

Background:

• Upper tract urothelial carcinoma (UTUC) is a rare malignancy.
• Concurrent bladder tumors are found in a significant minority of UTUC patients.
• Understanding the impact of concurrent bladder tumors on UTUC outcomes is crucial for treatment planning.

Purpose of the Study:

• To evaluate the clinical outcomes of UTUC patients.
• To assess the impact of concurrent bladder tumors on UTUC recurrence and survival.
• To determine the role of kidney-sparing surgery (KSS) in patients with concurrent bladder tumors.

Main Methods:

• Retrospective analysis of 1134 UTUC patients from the CROES-UTUC Registry (2014-2019).
• Multivariable Cox regression analysis was used to assess recurrence-free survival.
• Comparison of outcomes between patients with and without concurrent bladder tumors.

Main Results:

• Concurrent bladder tumors were present in 19.2% of patients.
• Concomitant bladder tumor was a risk factor for bladder recurrence (HR 1.874, p=0.020) but not UTUC recurrence (HR 0.876, p=0.812).
• Kidney-sparing surgery (KSS) and pathological T staging ≥ pT2 were significantly associated with UTUC recurrence.

Conclusions:

• The presence of a concurrent bladder tumor does not increase the risk of UTUC recurrence.
• Concurrent bladder tumors significantly increase the risk of bladder recurrence.
• Kidney-sparing surgery (KSS) can be considered in patients with concurrent bladder tumors as it does not affect bladder recurrence.