Mp35-16 Discriminative Performance of Aua 2020 Microscopic Hematuria Guidelines for Intermediate and High-Risk Patients in Predicting Neoplasms

You have accessJournal of UrologyBladder Cancer: Epidemiology & Evaluation II (MP35)1 May 2024MP35-16 DISCRIMINATIVE PERFORMANCE OF AUA 2020 MICROSCOPIC HEMATURIA GUIDELINES FOR INTERMEDIATE AND HIGH-RISK PATIENTS IN PREDICTING NEOPLASMS Emeka Udedibia, Kerli Orellana, Kenneth Solosky, Richard Amdur, and Simon Hall Emeka UdedibiaEmeka Udedibia , Kerli OrellanaKerli Orellana , Kenneth SoloskyKenneth Solosky , Richard AmdurRichard Amdur , and Simon HallSimon Hall View All Author Informationhttps://doi.org/10.1097/01.JU.0001009372.61513.54.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The American Urological Association (AUA) 2020 guidelines stratify patients with microhematuria into risk groups to identify those more likely to harbor neoplasms. This study assesses the predictive accuracy of the Intermediate and high-risk stratifications from these guidelines, focusing on specific clinical risk factors as outlined in the guidelines. METHODS: A retrospective analysis of 2,552 patients was performed to evaluate the association between mid and high AUA 2020 risk levels and the presence of neoplasms. Predictors set by the AUA guidelines, including age, gender, tobacco use, red blood cell count in urine (RBCs), and persistent microhematuria, were assessed. Fisher exact tests were applied to establish statistical significance (p<0.05). RESULTS: Among the intermediate (n=1107) and high-risk (n=1349) groups, 4% were diagnosed with neoplasm. Neoplasm cases were higher for high-risk patients. Specifically, high-risk patients showed a higher incidence of urothelial neoplasms at 3.11% versus 0.36% for intermediate risk, underscoring the guidelines' enhanced predictive power for this cohort (p<.0001) (Table 1). Conversely, the AUA stratification showed no association with renal cortical neoplasms (p=0.70). Age, particularly over 60 years, elevated urinary RBC counts, and tobacco use were reaffirmed as robust predictors for urothelial neoplasms. However, male gender also showed a significant association with urothelial neoplasm (p<.0001). Notably, persistent microscopic hematuria, as defined by the AUA guideline, was not a significant predictor (p=0.06). CONCLUSIONS: The AUA 2020 guidelines effectively stratify the risk of urothelial neoplasms in patients with microscopic hematuria. The risk factors used for stratification (age, urinary RBCs, tobacco use) are validated. However, the risk is higher for men than women. Notably, the guidelines did fall short in predicting renal cortical neoplasms, and persistent microscopic hematuria was not a significant risk factor. Further studies are recommended to validate these findings. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e587 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Emeka Udedibia More articles by this author Kerli Orellana More articles by this author Kenneth Solosky More articles by this author Richard Amdur More articles by this author Simon Hall More articles by this author Expand All Advertisement PDF downloadLoading ...