Mp38-16 Survival Benefit of Nephroureterectomy in Systemic Therapy Exposed Metastatic Upper Tract Urinary Urothelial Carcinoma Patients

You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma II (MP38)1 May 2024MP38-16 SURVIVAL BENEFIT OF NEPHROURETERECTOMY IN SYSTEMIC THERAPY EXPOSED METASTATIC UPPER TRACT URINARY UROTHELIAL CARCINOMA PATIENTS Simone Morra, Reha-Baris Incesu, Lukas Scheipner, Andrea Baudo, Letizia M. I. Jannello, Carolin Siech, Mario De Angelis, Zhe Tian, Massimiliano Creta, Gianluigi Califano, Claudia Colla' Ruvolo, Fred Saad, Shahrokh F. Shariat, Felix Chun, Ottavio De Cobelli, Gennaro Musi, Alberto Briganti, Derya Tilki, Sascha Ahyai, Luca Carmignagni, Nicola Longo, and Pierre I. Karakiewicz Simone MorraSimone Morra , Reha-Baris IncesuReha-Baris Incesu , Lukas ScheipnerLukas Scheipner , Andrea BaudoAndrea Baudo , Letizia M. I. JannelloLetizia M. I. Jannello , Carolin SiechCarolin Siech , Mario De AngelisMario De Angelis , Zhe TianZhe Tian , Massimiliano CretaMassimiliano Creta , Gianluigi CalifanoGianluigi Califano , Claudia Colla' RuvoloClaudia Colla' Ruvolo , Fred SaadFred Saad , Shahrokh F. ShariatShahrokh F. Shariat , Felix ChunFelix Chun , Ottavio De CobelliOttavio De Cobelli , Gennaro MusiGennaro Musi , Alberto BrigantiAlberto Briganti , Derya TilkiDerya Tilki , Sascha AhyaiSascha Ahyai , Luca CarmignagniLuca Carmignagni , Nicola LongoNicola Longo , and Pierre I. KarakiewiczPierre I. Karakiewicz View All Author Informationhttps://doi.org/10.1097/01.JU.0001008700.92603.b1.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: It is unknown whether the stage of the primary may influence the survival (OS) of metastatic upper tract urothelial carcinoma (mUTUC) patients treated with nephroureterectomy (NU) and systemic therapy (ST). We tested this hypothesis within a large-scale North American cohort. METHODS: Within Surveillance Epidemiology and End Results database 2000-2020, all mUTUC patients treated with ST+NU or with ST alone were identified. Kaplan-Maier plots depicted OS. Multivariable Cox regression (MCR) models tested for differences between ST+NU and ST alone predicting overall mortality (OM). All analyses were performed in localized (T1-T2) and then repeated in locally advanced (T3-T4) patients. RESULTS: Of all 728 mUTUC patients, 187 (26%) harbored T1-T2 vs 541 (74%) harbored T3-T4. In T1-T2 patients, the median OS was 20 months in ST+NU vs 10 months in ST alone. Moreover, in MCR analyses that also relied on three months' landmark analyses, the combination of ST+NU independently predicted lower OM (HR 0.37, p<0.001). Conversely, in T3-T4 patients, the median OS was 12 in ST+NU vs 10 months in ST alone. Moreover, in MCR analyses that also relied on three months' landmark analyses, the combination of ST+NU was not independently associated with lower OM (HR:0.85, p=0.1). CONCLUSIONS: In mUTUC patients, treated with ST, NU drastically improved survival in T1-T2 patients, even after strict methodological adjustments (multivariable and landmark analyses). However, this survival benefit did not apply to patients with locally more advanced disease (T3-T4). Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e648 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Simone Morra More articles by this author Reha-Baris Incesu More articles by this author Lukas Scheipner More articles by this author Andrea Baudo More articles by this author Letizia M. I. Jannello More articles by this author Carolin Siech More articles by this author Mario De Angelis More articles by this author Zhe Tian More articles by this author Massimiliano Creta More articles by this author Gianluigi Califano More articles by this author Claudia Colla' Ruvolo More articles by this author Fred Saad More articles by this author Shahrokh F. Shariat More articles by this author Felix Chun More articles by this author Ottavio De Cobelli More articles by this author Gennaro Musi More articles by this author Alberto Briganti More articles by this author Derya Tilki More articles by this author Sascha Ahyai More articles by this author Luca Carmignagni More articles by this author Nicola Longo More articles by this author Pierre I. Karakiewicz More articles by this author Expand All Advertisement PDF downloadLoading ...