Mp57-05 low Free Testosterone and Frailty Predict Overall Survival in Surgical Patients

Abstract

in diameter and of GII. UTUC developed in 59 (3.7%) of the patients; most of the patients were symptomatic and hematuria was the most common symptom in this cohort 64%, while UTUC was discovered on routine follow-up imaging in 30% of the patients. The median time for the development of UTUC was 20 (6-106 months). Most of the recurrences were on the ureter; either alone (39/59[66%) or ureteral with pelvicalyceal collecting system (10/59[17%), and (10/59[17%) were pelvicalyceal only. Among the isolated ureteral tumors (#39), distal ureteral tumors were more common (30/39[75%) than multicentric or proximal ureter (15% and 10% respectively). Bivariate analysis of the risk factors showed that gender, tumor size, site, tumor stage and grade were not predictors for the development of UTUC recurrence, but only bladder tumor number (single or multiple) and the number of previous recurrences were the predictors for UTUC recurrence (p[ 0.02 and 0.01 respectively). Three or more previous recurrences were the only predictors that sustained their significance in multivariate analysis (p[ 0.03 and 0.001 respectively). UTUC recurrence does not affect the overall survival.CONCLUSIONS: UTUC develops in 3.7% of patients with NMIBC. One-third (30%) of the patients were diagnosed with routine follow up imaging, so regular surveillance of the upper tract is still recommended to all patients. More strict surveillance is advised in the cases of those having had three or more bladder recurrences, yet the optimum protocol and frequency for upper tract imaging is to be determined by future prospective studies.