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Preoperative upper tract invasive diagnostic modalities are associated with intravesical recurrence following surgery for upper tract urothelial carcinoma : A population-based study
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- Liedberg, F. (author)
- Lund University, Dept. of Translational Medicine, Malmö, Sweden
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- Hagberg, O. (author)
- Lund University, Dept. of Translational Medicine, Malmö, Sweden
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- Haggström, C. (author)
- Uppsala University, Dept. of Surgical Sciences, Uppsala, Sweden
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- Aljabery, F. (author)
- Linköping University, Clinical and Experimental Medicine, Linköping, Sweden
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- Gårdmark, T. (author)
- Danderyd Hospital, Karolinska Institute, Clinical Sciences, Stockholm, Sweden
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- Hosseini, A. (author)
- Karolinska Institute, Dept. of Molecular Medicine and Surgery, Stockholm, Sweden
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- Jahnson, S. (author)
- Linköping University, Clinical and Experimental Medicine, Linköping, Sweden
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- Jerlström, T., 1969- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Dept. of Urology
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- Ströck, V. (author)
- Sahlgrenska University Hospital and Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Dept. of Urology, Gothenburg, Sweden
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- Söderkvist, K. (author)
- Umeå University, Dept. of Radiation Sciences, Umeå, Sweden
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- Ullén, A. (author)
- Karolinska Institute, Dept. of Oncology-Pathology, Stockholm, Sweden
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- Holmberg, L. (author)
- Uppsala University, Dept. of Surgical Sciences, Uppsala, Sweden
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- Bobjer, J. (author)
- Lund University, Dept. of Translational Medicine, Malmö, Sweden
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Lund University, Dept of Translational Medicine, Malmö, Sweden Uppsala University, Dept. of Surgical Sciences, Uppsala, Sweden (creator_code:org_t)
- Elsevier, 2023
- 2023
- English.
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In: European Urology. - : Elsevier. - 0302-2838 .- 1873-7560. ; 83:Suppl. 1, s. S720-S721
- Related links:
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https://urn.kb.se/re...
Abstract
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- Introduction & Objectives: Evidence based mainly on small retrospective series points to an increased risk of intravesical recurrence (IVR) after preoperative diagnostic ureteroscopy (URS) in upper tract urothelial carcinoma (UTUC). We investigated if preoperative invasive diagnostic modalities (IDM) are associated with IVR after radical surgery for UTUC. Secondly, risk of death from urothelial cancer and all causes was investigated.Materials & Methods: We investigated a population-based cohort of 1038 consecutive patients subjected to radical surgery for UTUC 2015–2019 in Sweden, using the Bladder Cancer Data Base Sweden (BladderBaSe 2.0), comprising all patients in the Swedish National Registry of Urinary Bladder Cancer. Risk estimates of IVR, death from urothelial cancer, and all causes following IDM (antegrade/retrograde uretero-pyelography and/or selective urine cytology/barbotage, and URS with or without concomitant biopsy) was assessed using multivariable Cox regression models adjusted for age, gender, clinical tumour stage, tumour location (renal pelvis/ureter/both), ipsilateral bladder cuff excision, previous bladder cancer, comorbidity, and educational level.Results: The study included 536 cases with and 502 without preoperative IDM. IDM was associated with increased risk of IVR (HR 1.24, 95% CI 1.03-1.52) and risk of urothelial cancer death (HR 1.56, CI 1.12-2.18), compared to no IDM after a median follow-up of 1.3 yrs. Stratified analysis for tumor location showed that IDM was associated with risk of IVR in ureteric cancer (HR 1.66, 95% CI 1.21-2.28) but not in renal pelvic cancer (HR 1.07, 95% CI 0.81-1.41). Limitations include the observational setting and the lack of information on tumour grade, multifocality and preoperative hydronephrosis.Conclusions: Worse outcomes for patients subjected to preoperative IDM highlight the need for carefully considering diagnostic decisions for UTUC patients, specifically in tumours located in the ureter.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
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- vet (subject category)
- art (subject category)
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- By the author/editor
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Liedberg, F.
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Hagberg, O.
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Haggström, C.
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Aljabery, F.
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Gårdmark, T.
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Hosseini, A.
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Jahnson, S.
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Jerlström, T., 1 ...
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Ströck, V.
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Söderkvist, K.
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Ullén, A.
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Holmberg, L.
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Bobjer, J.
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Urology and Neph ...
- Articles in the publication
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European Urology
- By the university
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Örebro University