Is Regular Radiographic Upper Urinary Tract Imaging for Surveillance of Non-Muscle Invasive Bladder Cancer Justified?
Patients with non-muscle invasive (NMI) urothelial bladder cancer (BC) are at increased risk for the development of a secondary upper-urinary-tract urothelial carcinoma (UTUC). We aimed to assess the usefulness of routine upper-tract imaging surveillance during NMIBC follow-up in a patient cohort of...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-11-01
|
| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/14/22/5586 |
| _version_ | 1797465717566603264 |
|---|---|
| author | Uwe Bieri Benedikt Kranzbühler Burkhardt Seifert Birgit Maria Helmchen Alexander Gu Basil Kaufmann Dejan Lavrek Thomas Scherer Marian S. Wettstein Cédric Poyet Thomas Hermanns |
| author_facet | Uwe Bieri Benedikt Kranzbühler Burkhardt Seifert Birgit Maria Helmchen Alexander Gu Basil Kaufmann Dejan Lavrek Thomas Scherer Marian S. Wettstein Cédric Poyet Thomas Hermanns |
| author_sort | Uwe Bieri |
| collection | DOAJ |
| description | Patients with non-muscle invasive (NMI) urothelial bladder cancer (BC) are at increased risk for the development of a secondary upper-urinary-tract urothelial carcinoma (UTUC). We aimed to assess the usefulness of routine upper-tract imaging surveillance during NMIBC follow-up in a patient cohort of a tertiary academic center. All routine upper-tract-imaging scans using computerized tomography urography (CTU) between 2003 and 2016 were assessed for UTUC detection. A total of 315 patients were analyzed. Initial tumor stage was Ta in 207 patients (65.7%), T1 in 98 patients (31.1%) and pure CIS in 10 patients (3.2%). A total of 149 (47.3%) presented with low-grade (LG), and 166 (52.7%) with high-grade (HG) disease. Median follow-up was 48 months (IQR: 55). Four patients (1.2%) were diagnosed with UTUC during follow-up. All four patients presented with initial Ta HG BC. Two of the patients (50%) were diagnosed by routine upper tract imaging. The other two patients were diagnosed after development of symptoms. The 5- and 10-year UTUC-free survival was 98.5% (standard error (SE) 0.9) and 97.6% (SE 1.3), respectively. UTUCs were detected exclusively in patients with initial HG disease, indicating that upper-tract surveillance might only be necessary in these patients. |
| first_indexed | 2024-03-09T18:26:30Z |
| format | Article |
| id | doaj.art-87ce0fc660d44d9eab2f0dd281cb1df0 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T18:26:30Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-87ce0fc660d44d9eab2f0dd281cb1df02023-11-24T07:53:33ZengMDPI AGCancers2072-66942022-11-011422558610.3390/cancers14225586Is Regular Radiographic Upper Urinary Tract Imaging for Surveillance of Non-Muscle Invasive Bladder Cancer Justified?Uwe Bieri0Benedikt Kranzbühler1Burkhardt Seifert2Birgit Maria Helmchen3Alexander Gu4Basil Kaufmann5Dejan Lavrek6Thomas Scherer7Marian S. Wettstein8Cédric Poyet9Thomas Hermanns10Department of Urology, University Hospital Zürich, University of Zürich, 8091 Zürich, SwitzerlandDepartment of Urology, University Hospital Zürich, University of Zürich, 8091 Zürich, SwitzerlandEpidemiology, Biostatistics and Prevention Institute, University of Zürich, 8006 Zürich, SwitzerlandDepartment of Pathology, and Molecular Pathology, University Hospital of Zurich, University of Zurich, 8091 Zürich, SwitzerlandDepartment of Urology, University Hospital Zürich, University of Zürich, 8091 Zürich, SwitzerlandDepartment of Urology, University Hospital Zürich, University of Zürich, 8091 Zürich, SwitzerlandDepartment of Urology, University Hospital Zürich, University of Zürich, 8091 Zürich, SwitzerlandDepartment of Urology, University Hospital Zürich, University of Zürich, 8091 Zürich, SwitzerlandDepartment of Urology, University Hospital Zürich, University of Zürich, 8091 Zürich, SwitzerlandDepartment of Urology, University Hospital Zürich, University of Zürich, 8091 Zürich, SwitzerlandDepartment of Urology, University Hospital Zürich, University of Zürich, 8091 Zürich, SwitzerlandPatients with non-muscle invasive (NMI) urothelial bladder cancer (BC) are at increased risk for the development of a secondary upper-urinary-tract urothelial carcinoma (UTUC). We aimed to assess the usefulness of routine upper-tract imaging surveillance during NMIBC follow-up in a patient cohort of a tertiary academic center. All routine upper-tract-imaging scans using computerized tomography urography (CTU) between 2003 and 2016 were assessed for UTUC detection. A total of 315 patients were analyzed. Initial tumor stage was Ta in 207 patients (65.7%), T1 in 98 patients (31.1%) and pure CIS in 10 patients (3.2%). A total of 149 (47.3%) presented with low-grade (LG), and 166 (52.7%) with high-grade (HG) disease. Median follow-up was 48 months (IQR: 55). Four patients (1.2%) were diagnosed with UTUC during follow-up. All four patients presented with initial Ta HG BC. Two of the patients (50%) were diagnosed by routine upper tract imaging. The other two patients were diagnosed after development of symptoms. The 5- and 10-year UTUC-free survival was 98.5% (standard error (SE) 0.9) and 97.6% (SE 1.3), respectively. UTUCs were detected exclusively in patients with initial HG disease, indicating that upper-tract surveillance might only be necessary in these patients.https://www.mdpi.com/2072-6694/14/22/5586urologic neoplasmsupper-urinary-tract urothelial cancersurveillancediagnostic imaging |
| spellingShingle | Uwe Bieri Benedikt Kranzbühler Burkhardt Seifert Birgit Maria Helmchen Alexander Gu Basil Kaufmann Dejan Lavrek Thomas Scherer Marian S. Wettstein Cédric Poyet Thomas Hermanns Is Regular Radiographic Upper Urinary Tract Imaging for Surveillance of Non-Muscle Invasive Bladder Cancer Justified? Cancers urologic neoplasms upper-urinary-tract urothelial cancer surveillance diagnostic imaging |
| title | Is Regular Radiographic Upper Urinary Tract Imaging for Surveillance of Non-Muscle Invasive Bladder Cancer Justified? |
| title_full | Is Regular Radiographic Upper Urinary Tract Imaging for Surveillance of Non-Muscle Invasive Bladder Cancer Justified? |
| title_fullStr | Is Regular Radiographic Upper Urinary Tract Imaging for Surveillance of Non-Muscle Invasive Bladder Cancer Justified? |
| title_full_unstemmed | Is Regular Radiographic Upper Urinary Tract Imaging for Surveillance of Non-Muscle Invasive Bladder Cancer Justified? |
| title_short | Is Regular Radiographic Upper Urinary Tract Imaging for Surveillance of Non-Muscle Invasive Bladder Cancer Justified? |
| title_sort | is regular radiographic upper urinary tract imaging for surveillance of non muscle invasive bladder cancer justified |
| topic | urologic neoplasms upper-urinary-tract urothelial cancer surveillance diagnostic imaging |
| url | https://www.mdpi.com/2072-6694/14/22/5586 |
| work_keys_str_mv | AT uwebieri isregularradiographicupperurinarytractimagingforsurveillanceofnonmuscleinvasivebladdercancerjustified AT benediktkranzbuhler isregularradiographicupperurinarytractimagingforsurveillanceofnonmuscleinvasivebladdercancerjustified AT burkhardtseifert isregularradiographicupperurinarytractimagingforsurveillanceofnonmuscleinvasivebladdercancerjustified AT birgitmariahelmchen isregularradiographicupperurinarytractimagingforsurveillanceofnonmuscleinvasivebladdercancerjustified AT alexandergu isregularradiographicupperurinarytractimagingforsurveillanceofnonmuscleinvasivebladdercancerjustified AT basilkaufmann isregularradiographicupperurinarytractimagingforsurveillanceofnonmuscleinvasivebladdercancerjustified AT dejanlavrek isregularradiographicupperurinarytractimagingforsurveillanceofnonmuscleinvasivebladdercancerjustified AT thomasscherer isregularradiographicupperurinarytractimagingforsurveillanceofnonmuscleinvasivebladdercancerjustified AT marianswettstein isregularradiographicupperurinarytractimagingforsurveillanceofnonmuscleinvasivebladdercancerjustified AT cedricpoyet isregularradiographicupperurinarytractimagingforsurveillanceofnonmuscleinvasivebladdercancerjustified AT thomashermanns isregularradiographicupperurinarytractimagingforsurveillanceofnonmuscleinvasivebladdercancerjustified |