Cumulative incidence and risk factors of UTUC recurrence after radical cystectomy

What is it about?

This study aimed to evaluate the cumulative incidence of upper tract urothelial carcinoma (UTUC) recurrence and identify its risk factors in patients who underwent radical cystectomy (RC). Out of 365 patients, 60% had the bladder-only type, 30% had the one-extension type, and 10% had the both-extension type. UTUC recurred in 25 patients, with cumulative incidences of 3.7% at 5 years and 8.3% at 10 years. The cancer extension pattern in cystectomy specimens was a significant predictor of UTUC recurrence, with hazard ratios of 3.12 and 5.96 for the one-extension and both-extension types, respectively. Clinical guidelines recommend annual renal ultrasonography over 5 years, complemented by urinary cytology as clinically indicated, for monitoring UTUC recurrence.

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Photo by Samuel Ferrara on Unsplash

Photo by Samuel Ferrara on Unsplash

Why is it important?

This research is important because it helps identify patients at high risk for upper tract urothelial carcinoma (UTUC) recurrence after radical cystectomy (RC). Identifying high-risk patients allows for more targeted and personalized surveillance, improving patient outcomes and quality of life. Key Takeaways: 1. The cancer extension pattern in cystectomy specimens is a significant predictor of UTUC recurrence. 2. The one-extension and both-extension types are associated with higher cumulative incidences of UTUC recurrence compared to the bladder-only type. 3. Patients with high epigenetic changes in the normal urothelium might allow a wider extension of bladder cancer and could also reflect epigenetic conditions of the remnant urothelium in the upper urinary tract, followed by a high incidence of UTUC recurrence. 4. Focusing on the cancer extension patterns in cystectomy specimens can be more useful and specific when predicting UTUC recurrence after RC.