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Should follow-up cystoscopy be performed in upper-tract urothelial carcinoma patients managed with radical nephroureterectomy after a five-year bladder tumor-free period?

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机构: [1]Peking Univ First Hosp, Dept Urol, 8 Xishiku St, Beijing 100034, Peoples R China [2]Peoples Hosp Zhongmu Cty, Dept Urol, 2996 Shangdu Ave, Zhengzhou 451450, Henan, Peoples R China [3]Peking Univ, Inst Urol, Beijing, Peoples R China [4]Natl Urol Canc Ctr, Beijing, Peoples R China [5]Fujian Univ Tradit Chinese Med, Dept Urol, Peoples Hosp Affiliated 3, 363 Guobin Ave, Fuzhou 350108, Fujian, Peoples R China [6]First Peoples Hosp Zhaotong, Dept Urol, 35 Yiwei Rd, Zhaotong, Yunnan, Peoples R China
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关键词: Upper-tract urothelial carcinoma Late bladder recurrence Risk factor

摘要:
There is a lack of consensus regarding the follow-up schedule for patients with upper-tract urothelial carcinoma (UTUC) who remain bladder recurrence-free for 5 years after radical nephroureterectomy (RNU). In this study, we aimed to identify the risk factors for late recurrence in UTUC patients who remained bladder recurrence-free for at least 5 years post-RNU. Data from a large single-center Chinese institution were retrospectively analyzed. A total of 939 patients who remained recurrence-free for at least 5 years post-RNU were included in this study. To determine the risk factors for late bladder recurrence after RNU, we applied univariate and multivariate analyses using the Fine-Gray model, considering death as a competing risk. During a median follow-up of 97 months, 45 (4.8%) developed bladder recurrence, 207 (22%) died, and 61 (6.5%) succumbed to UTUC. The cumulative risk of bladder recurrence was 6.3% at 10 years and 13.9% at 15 years. The peak incidence of late bladder recurrence was observed between 70 and 90 months post-RNU. Univariate analysis revealed that Chronic Kidney Disease (CKD) stage 5 was significantly associated with late bladder recurrence.Multivariate analysis revealed that CKD stage 5 and tumor diameter less than 3 cm were independent risk factors for late bladder recurrence. These findings indicate that late bladder recurrence is uncommon and patients with CKD stage 5 or tumor diameter less than 3 cm are at a higher risk of late bladder recurrence, warranting prolonged cystoscopic surveillance for for 5 to 10 years post-RNU.

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大类 | 4 区 医学
小类 | 4 区 内分泌学与代谢 4 区 肿瘤学
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出版当年[2024]版:
最新[2023]版:
Q2 ONCOLOGY Q3 ENDOCRINOLOGY & METABOLISM

影响因子: 最新[2023版] 最新五年平均 出版当年[2024版] 出版当年五年平均 出版前一年[2023版]

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第一作者机构: [1]Peking Univ First Hosp, Dept Urol, 8 Xishiku St, Beijing 100034, Peoples R China [3]Peking Univ, Inst Urol, Beijing, Peoples R China [4]Natl Urol Canc Ctr, Beijing, Peoples R China
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通讯机构: [1]Peking Univ First Hosp, Dept Urol, 8 Xishiku St, Beijing 100034, Peoples R China [3]Peking Univ, Inst Urol, Beijing, Peoples R China [4]Natl Urol Canc Ctr, Beijing, Peoples R China
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