MP38-20 RISK OF UPPER URINARY TRACT DISSEMINATION IN cT3 BLADDER CANCER PATIENTS TREATED WITH DOUBLE-J STENT VERSUS NEPHROSTOMY TUBE PRIOR TO RADICAL CYSTECTOMY

You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma II (MP38)1 May 2024MP38-20 RISK OF UPPER URINARY TRACT DISSEMINATION IN cT3 BLADDER CANCER PATIENTS TREATED WITH DOUBLE-J STENT VERSUS NEPHROSTOMY TUBE PRIOR TO RADICAL CYSTECTOMY Mario de Angelis, Francesco Soria, Benjamin Pradere, Luca Afferi, Francesco Montorsi, Alberto Briganti, Shahrokh F. Shariat, Peter Wiklund, David D'Andrea, Simone Albissini, Andrea Mari, Francesco Del Giudice, Wojciech Krajewski, Ekaterina Laukhtina, Jeremy Yuen-Chun Teoh, Keiichiro Mori, Laura S. Mertens, Andrea Gallioli, Renate Pichler, and Marco Moschini Mario de AngelisMario de Angelis , Francesco SoriaFrancesco Soria , Benjamin PradereBenjamin Pradere , Luca AfferiLuca Afferi , Francesco MontorsiFrancesco Montorsi , Alberto BrigantiAlberto Briganti , Shahrokh F. ShariatShahrokh F. Shariat , Peter WiklundPeter Wiklund , David D'AndreaDavid D'Andrea , Simone AlbissiniSimone Albissini , Andrea MariAndrea Mari , Francesco Del GiudiceFrancesco Del Giudice , Wojciech KrajewskiWojciech Krajewski , Ekaterina LaukhtinaEkaterina Laukhtina , Jeremy Yuen-Chun TeohJeremy Yuen-Chun Teoh , Keiichiro MoriKeiichiro Mori , Laura S. MertensLaura S. Mertens , Andrea GallioliAndrea Gallioli , Renate PichlerRenate Pichler , and Marco MoschiniMarco Moschini View All Author Informationhttps://doi.org/10.1097/01.JU.0001008700.92603.b1.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Preoperative hydronephrosis at the time of radical cystectomy (RC) is considered a poor prognostic factor. Sparse data exists regarding the optimal kidney decompression performed with percutaneous nephrostomy (PCN) or double-J stenting (DJ) and the subsequent risk of developing upper tract dissemination (UTD). METHODS: We relied from a multi-institutional database of cT3NanyM0 bladder cancer patients treated with RC and bilateral lymph-node dissection without history of previous upper tract urinary carcinoma in ten tertiary care centers between 1990 and 2017. Patients who were diagnosed with hydronephrosis and treated either with PCN or DJ before RC were included in our study. Drainage modality was chosen at discretion of the attending urologist in each center. Primary outcomes of the study was UTD within 2 years after surgery. Kaplan-Meier (KM) depicted the two-year recurrence-free survival in upper urinary tract (2-RFS). RESULTS: Of 492 patients with preoperative hydronephrosis, 369 (75%) were drained through PCN vs. 123 (25%) with DJ. Bilateral hydronephrosis occurred in 152 (30.9%) patients. The rate of >=3 grade hydronephrosis was higher in patients drained through PCN-placement compared to DJ-drained (30 vs. 15%, respectively, p<0.01). During a median follow up of 38 months, 22 recurrences were recorded (4.4%). Of these, 3 (1.6%) occurred in DJ-drained patients vs. 19 (3.8%) in PCN-drained patients (p=0.9). KM analysis showed no difference in two-year recurrence-free survival between the two treatment modalities (p=0.7). CONCLUSIONS: The risk of UTD is rare, even in patients with preoperative hydronephrosis occurring in 4,4% of patients. We found no increased risk for patients who underwent kidney decompression with DJ. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e650 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Mario de Angelis More articles by this author Francesco Soria More articles by this author Benjamin Pradere More articles by this author Luca Afferi More articles by this author Francesco Montorsi More articles by this author Alberto Briganti More articles by this author Shahrokh F. Shariat More articles by this author Peter Wiklund More articles by this author David D'Andrea More articles by this author Simone Albissini More articles by this author Andrea Mari More articles by this author Francesco Del Giudice More articles by this author Wojciech Krajewski More articles by this author Ekaterina Laukhtina More articles by this author Jeremy Yuen-Chun Teoh More articles by this author Keiichiro Mori More articles by this author Laura S. Mertens More articles by this author Andrea Gallioli More articles by this author Renate Pichler More articles by this author Marco Moschini More articles by this author Expand All Advertisement PDF downloadLoading ...