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Prognostic impact of tumor ureteral invasion on recurrence after radical cystectomy

  • Urology - Original Paper
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Abstract

Purpose

Several preoperative factors have been suggested to be risk factors of disease recurrence after radical cystectomy. There is no study focusing on the impact on prognosis of bladder tumor ureteral invasion in preoperative imaging.

Methods

The study population consisted of 136 patients, all of whom underwent radical cystectomy during the period between 2007–2019. We excluded patients with concurrent or a history of upper tract urothelial carcinoma and who underwent radical cystectomy for other cancers or nononcologic reasons. The starting point of this study was the timing of neoadjuvant chemotherapy or radical cystectomy and the endpoint was the timing of disease recurrence. To identify the factors influencing recurrence, univariate and multivariate analyses were performed using the Cox proportional hazard model. Recurrence-free survival curves were constructed using the Kaplan–Meier method.

Results

Ureteral invasion was observed in 20 (14.7%) patients. Disease recurrence was observed in 11 (55.0%) of 20 ureteral invasion positive patients and 35 (30.2%) of 116 ureteral invasion negative patients, respectively. In the ureteral invasion positive group, clinical T and N stage were higher and hydronephrosis were more common than in the ureteral invasion negative group. According to the multivariate analysis, ureteral invasion (hazard ratio: 2.307, p = 0.016) and clinical N stage ≥ 1 (hazard ratio: 2.140, p = 0.028) were independent risk factors for postoperative recurrence. In the ureteral invasion positive group, more local recurrences were observed.

Conclusion

This study suggested that ureteral invasion in preoperative imaging is a significant risk factor for postoperative recurrence.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Funding

There are no funding resources in this study.

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Authors and Affiliations

  1. Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan

    Takafumi Saito, Kazuhiro Matsumoto, Nobuyuki Tanaka, Yota Yasumizu, Toshikazu Takeda, Shinya Morita, Takeo Kosaka, Ryuichi Mizuno, Hiroshi Asanuma & Mototsugu Oya

  2. Department of Urology, Kawasaki Municipal Hospital, 12-1 Shinkawadori, Kawasaki-Ku, Kawasaki, Kanagawa, 210-0013, Japan

    Keishiro Fukumoto & Satoshi Hara

Authors
  1. Takafumi Saito
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  2. Kazuhiro Matsumoto
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  3. Nobuyuki Tanaka
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  4. Keishiro Fukumoto
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  5. Yota Yasumizu
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  6. Toshikazu Takeda
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  7. Shinya Morita
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  8. Takeo Kosaka
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  9. Ryuichi Mizuno
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  10. Hiroshi Asanuma
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  11. Satoshi Hara
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  12. Mototsugu Oya
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Corresponding author

Correspondence to Kazuhiro Matsumoto.

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There are no conflict of interest in this study.

Ethical approval

This study was approved by the Ethics Committee of the Keio University School of Medicine, Tokyo, Japan, and is in line with the Helsinki Declaration.

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Saito, T., Matsumoto, K., Tanaka, N. et al. Prognostic impact of tumor ureteral invasion on recurrence after radical cystectomy. Int Urol Nephrol 56, 129–135 (2024). https://doi.org/10.1007/s11255-023-03808-6

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  • DOI: https://doi.org/10.1007/s11255-023-03808-6

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