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Prognostic factors and effect of existing predictive models in oligo-metastatic urothelial carcinoma (YUSHIMA study)
Kenji Tanabe1, Soichiro Yoshida2, Tomoki Kimura3
1Department of Urology, Institute of Science Tokyo, Bunkyo-Ku, 1 - 5- 45, Yushima, Bunkyo-ku, Tokyo, 113 - 8510, Japan.
Background:
Oligo-metastatic urothelial carcinoma (OMUC), characterized by a limited number of metastases, demonstrates better survival outcomes compared to poly-metastatic urothelial carcinoma (PMUC), but some patients with OMUC exhibit poor prognosis. However, a comprehensive analysis of prognostic factors in OMUC remains lacking. This study aimed to determine prognostic factors in patients with OMUC from a multicenter dataset and evaluate the effect of existing predictive models.
Methods:
This retrospective study included 443 patients with metastatic urothelial carcinoma (MUC) from 15 institutions (YUSHIMA study). OMUC involved cases with three or fewer metastases. Clinical data were analyzed for associations with overall survival (OS) utilizing Cox regression models. The effect of existing predictive models (Bajorin, Bellmunt, and Apolo) on OMUC prognosis was evaluated.
Results:
Patients with OMUC (n = 182) demonstrated better Eastern Cooperative Oncology Group-performance status (ECOG-PS) and lower visceral metastasis frequency compared to PMUC (n = 261). Patients with OMUC exhibited a median OS of 26.1 months vs. 13.7 months for PMUC (p < 0.01). Poor ECOG-PS, liver metastasis, and hypoalbuminemia appeared as independent poor prognostic factors for OS in OMUC. The Bajorin, Bellmunt, and Apolo models significantly correlated with OS in patients with OMUC (p < 0.01, for all).
Conclusion:
Known prognostic factors for MUC were confirmed as significant prognostic factors for OS in OMUC, and existing prognostic models applied to OMUC. These results are expected to contribute to developing more effective treatment strategies for OMUC.
