Mp38-14 Adoption of Robot-Assisted Radical Nephroureterectomy Allows Minimally Invasive Options for Management of Upper Tract Urothelial Carcinoma in Geriatric Patients: Comparison With Non-Geriatric Patients at Intermediate Term Oncologic Follow Up

You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma II (MP38)1 May 2024MP38-14 ADOPTION OF ROBOT-ASSISTED RADICAL NEPHROURETERECTOMY ALLOWS MINIMALLY INVASIVE OPTIONS FOR MANAGEMENT OF UPPER TRACT UROTHELIAL CARCINOMA IN GERIATRIC PATIENTS: COMPARISON WITH NON-GERIATRIC PATIENTS AT INTERMEDIATE TERM ONCOLOGIC FOLLOW UP Justin Refugia, Parth Thakker, Timothy O'Rourke, and Ashok Hemal Justin RefugiaJustin Refugia , Parth ThakkerParth Thakker , Timothy O'RourkeTimothy O'Rourke , and Ashok HemalAshok Hemal View All Author Informationhttps://doi.org/10.1097/01.JU.0001008700.92603.b1.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The peak incidence of upper tract urothelial carcinoma (UTUC) is currently 73 years old. Radical nephroureterectomy is the standard of care for high grade and infiltrative UTUC, however the utility in geriatric patients is controversial. In our study, we investigated the safety and oncologic efficacy of minimally invasive RNU for UTUC in our large series of geriatric patients. METHODS: From our prospectively maintained, single-center database of patients with UTUC that underwent RNU, we established two groups according to age (≥75 and <75 years old) for a retrospective cohort study. Included patients must have undergone robot assisted RNU. The groups were compared to assess the primary outcomes of UTUC-related recurrence of disease (assessed by surveillance cystoscopy with cross-sectional imaging) and perioperative Clavien-Dindo (C.D., Severe: Grade 3-5) complications. Recurrence free survival (RFS) curves were estimated with Kaplan-Meier analysis for all patients. RESULTS: From 2009 to 2023, 145 patients met inclusion criteria with 39% in the ≥75 cohort (median age 80 years) versus the remaining 61% in the <75 cohort (median age 65 years). Overall median follow up was 32 months. Between the ≥75 and <75 cohorts: No differences in 30-day major (C.D. 3-5) complications (2% and 1%, respectively). Bladder recurrence specific RFS was similar at 1 year (63% vs 72%, respectively) and 3 years (26% vs 39%, respectively; HR 0.70, 95% CI 0.35,1.40). Metastatic specific RFS was also similar at 1 year (72% vs. 81%, respectively) and 3 years (36% vs 61%, respectively; HR 0.71, 95% CI 0.30, 1.70). Lastly, cancer-specific survival was similar at 1 year (69% vs 79%, respectively and 3 years (41% vs 34%, respectively; HR 1.15, 95% CI 0.49, 2.68). CONCLUSIONS: Our data suggest that, when compared to younger patients with UTUC, geriatric patients undergoing robot assisted RNU have similar oncologic outcomes with no increased risk of perioperative complications. Further studies are warranted to determine factors that increase the risk of UTUC-related recurrences in geriatric patients. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e647 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Justin Refugia More articles by this author Parth Thakker More articles by this author Timothy O'Rourke More articles by this author Ashok Hemal More articles by this author Expand All Advertisement PDF downloadLoading ...