Abstract: PD57-06
Sources of Funding: None

Introduction

Upper tract urothelial carcinoma (UTUC) accounts for <5% of all urothelial cancers. Studies show that urothelial bladder carcinoma recurrence (UBCR) occurs in 22–47% of deNovo UTUC (dNUTUC) patients. Our goal was to compare UBCR rates, predictors and disease specific mortality (DSM) in different dNUTUC locations.

Methods

The SEER database was queried for all patients with dNUTUC from 1988-2013, who developed UBCR. Data collected consisted of demographic, clinical parameters including tumor location, pathological and survival data. Patients were stratified according to their dNUTUC location (renal pelvis [RENPEL] vs. ureteral [UL]) and compared for time to UBCR and bladder cancer (BC) DSM.

Results

This cohort included 15,298 patients with dNUTUC. UBCR was diagnosed in 51.6% and 51.2% of RENPEL and UL tumors, respectively (p=0.639), (N=7179). Table 1 presents the demographic, pathologic and median follow-up data of the UBCR patients, stratified according to dNUTUC location. Approximately a fifth of these UBCRs are muscle invasive. Covariates associated with UBCR include RENPEL tumors (OR=1.318, 95% C.I. 1.027-1.691. p=0.03), less advanced disease (OR=0.587, 95% C.I. 0.434-0.793, p=0.001) and dNUTUC surgical treatment (OR=5.78, 95% C.I. 1.846-18.106, p=0.003). Interestingly, 50% and 75% of the dNUTUC patients are diagnosed with UBCR within 67 and 133 months, respectively, with higher grade UBCRs being diagnosed earlier. Survival data shows age, black race and more advanced disease being predictors of BC DSM (table 2).

Conclusions

These data suggest that RENPEL dNUTUC tumors consist of a higher risk for developing UBCR, especially when less advanced and treated surgically. Postoperative follow-up of dNUTUC patients should include routine cystoscopies for at least 11 years, to diagnose 75% of UBCR. Worse BC DSM is associated with black race and older patients with a more advanced disease.

Funding

None