Clinical Practice Points
- •To date, the prognostic role of prior bladder cancer (BCa) among patients with upper tract urothelial carcinoma (UTUC) is still poorly addressed.
- •We aimed to investigate the role of prior BCa on any recurrence (aR), distant metastasis (DM), and bladder recurrence following RNU among low-grade (LG) and high-grade (HG) UTUC patients.
- •We retrospectively analyzed a multicenter cohort of 1,580 patients treated with radical nephroureterectomy (RNU) for UTUC. Median follow-up was 4 years.
- •The Kaplan-Meier curves were applied to assess aR, DM, and bladder recurrence, computed from the time of RNU. Multivariable Cox models were generated to predict the risk of aR, DM, and bladder recurrence. All analyses were stratified by tumor grade (LG and HG), site of recurrence (aR, DM, and bladder recurrence), and prior history of BCa (no prior BCa, non-muscle-invasive [NMIBC], and muscle-invasive bladder cancer [MIBC]).
- •Both LG and HG UTUC patients with prior BCa had a significantly increased risk of aR and bladder recurrence on multivariable Cox models, compared to individuals with no prior BCa.
- •The main strength of our paper is represented by the fact that this is the first study in which analyses were stratified according to both UTUC grade and muscle-invasiveness of prior BCa history. Additionally, our cohort represent the largest cohort available in literature that evaluates the role of prior BCa on aR after RNU for UTUC.
- •The present study is limited by its retrospective design and the lack of some information on prior BCa, such as multifocality or previous intravesical therapy.
Patients and Methods
Abbreviations:UTUC (upper tract urothelial carcinoma), RNU (radical nephroureterectomy), BCa (bladder cancer), AC (adjuvant chemotherapy), NMIBC (non-muscle-invasive bladder cancer), MIBC (muscle-invasive bladder cancer), HG (high grade), LG (low grade), CI (confidence interval), HR (hazard ratio)
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