Dr. Bree investigated the timing of UTUC diagnosis (prior to NMIBC diagnosis vs. synchronous or metachronous disease) on BCG response. In a cohort of 577 patients treated with induction BCG at a single institution, 11% were diagnosed with UTUC. Patients with UTUC exhibited more multifocal tumors and prostatic urethral involvement relative to those without a history of UTUC. Notably, BCG was less efficacious in patients with a history of UTUC as these patients exhibited higher rates of recurrence (60% vs. 36%, P=0.0002) and stage progression (25% vs. 11%, P=0.005). There was no difference in recurrence or progression when stratified by timing of UTUC diagnosis. High clinical suspicion of panurothelial disease is necessary for nonresponders with disease patterns associated with occult UTUC (multifocality, PU involvement).
Presented by: Kelly Bree, MD, Society of Urologic Oncology (SUO) Fellow at the MD Anderson Cancer Center, Houston, Texas
Written by: Dr. Patrick Hensley, Urologic Oncology Fellow at MD Anderson Cancer Center, Twitter: @pjhensley11, with Ashish Kamat, MD, MBBS, President of The International Bladder Cancer Network (IBCN), The International Bladder Cancer Group (IBCG), and Professor of the Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, Twitter: @UroDocAsh, at the International Bladder Cancer Network (IBCN) Annual Meeting, #IBCN2020, October 17, 2020.