In this retrospective analysis, the authors included 468 upper tract urothelial carcinoma (UTUC) patients who developed IVR from the SEER database. They identified several independent risk factors including age at IVR ≥ 80 years, UTUC stage ≥ T3, bladder cancer stage T1, and bladder cancer stage ≥ T2. Interestingly, a time interval of > 24 months between UTUC and bladder cancer was found to be independently associated with better CSS.
The 1-, 3-, and 5-year predictive accuracy of the nomogram were 0.74, 0.70, and 0.71, respectively. Additionally, the 1-, 3-, and 5-year calibration curves demonstrated perfect agreement between the nomogram-predicted and the actual CSS.
Recent molecular studies have highlighted that at the genomic level, bladder cancers that develop following UTUC are 'drop metastases'. Our group recently discovered that UTUC has a distinct luminal-papillary and T-cell depleted phenotype. Understanding whether these subtypes are stable in IVR tumors is important for determining the optimal interventions.
Written by: Bishoy M. Faltas, MD, Director of Bladder Cancer Research, Englander Institute for Precision Medicine, Weill Cornell Medicine, New York City, New York
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