Current surveillance of bladder recurrence for upper tract urothelial carcinoma (UTUC) is limited by invasiveness and sensitivity. There is an urgent need for noninvasive detection tool. We previously developed utLIFE, a urine tumor DNA model combining mutation profiling and fragmentomics. This study validates its utility for surveillance prediction.
This prospective cohort included 47 UTUC patients undergoing radical nephroureterectomy (RNU). Serial urine samples were collected: pre-RNU (n = 47), post-RNU (n = 47), and at 3 to 6 months after RNU (n = 32). Kaplan-Meier curve (KM) analysis was used to compare recurrence-free survival (RFS), which was radiologically diagnosed with bladder cancer via CT.
The sensitivity of utLIFE at 3 to 6 months for predicting RFS were 83.3%, surpassing corresponding urine cytology and cystoscopy (16.7%). Notably, utLIFE positivity at 3 to 6 months demonstrated strong predictive value for RFS (P = 0.001). Dynamic utLIFE between post-RNU and 3 to 6 months, proved particularly informative, with both conversion from negative to positive status (P = 0.044) and persistent positivity (P = 0.005) serving as significant predictors of RFS. In patients receiving adjuvant therapy, utLIFE measurements effectively tracked treatment response. utLIFE preceded radiographic recurrence detection by a median of 5.67 months (P = 0.008), highlighting its potential for early identification.
This study establishes utLIFE as a noninvasive and promising monitoring tool for early recurrence detection.
Urologic oncology. 2026 Jul 09 [Epub ahead of print]
Wei Zuo, Qi Tang, Xuanjun Guo, Jilong Zhang, Wei Yu, Yanrui Zhang, Huanqing Cheng, Jian Lin, Liqun Zhou, Xuesong Li
Department of Urology, Peking University First Hospital, Beijing, China; Institute of Urology, Peking University, Beijing, China; National Urological Cancer Center, Beijing, China., Acornmed Biotechnology Co., Ltd., Beijing, China., Department of Urology, Peking University First Hospital, Beijing, China; Institute of Urology, Peking University, Beijing, China; National Urological Cancer Center, Beijing, China. Electronic address: ., Department of Urology, Peking University First Hospital, Beijing, China; Institute of Urology, Peking University, Beijing, China; National Urological Cancer Center, Beijing, China. Electronic address: .