| 論文種別 | 原著(症例報告除く) |
| 言語種別 | 英語 |
| 査読の有無 | その他(不明) |
| 表題 | Metachronous contralateral recurrence in upper tract urothelial carcinoma: a multi-institutional competing-risks analysis from the ROBUUST 3.0 registry. |
| 掲載誌名 | 正式名：Urology practice 略 称：Urol Pract ISSNコード：23520787/23520779 |
| 掲載区分 | 国外 |
| 巻・号・頁 | pp.Online ahead of print |
| 著者・共著者 | Francesco Ditonno, Alessandro Veccia, Giacomo Musso, Ithaar H Derweesh, Zhenjie Wu, Linhui Wang, Firas Abdollah, Alfonso Santangelo, Carlo Silvani, Alex Stephens, Giuseppe Simone, Gabriele Tuderti, Flavia Proietti, Randall Lee, Alexander Kutikov, Ottavio De Cobelli, Marco Tozzi, Matteo Ferro, Francesco Porpiglia, Daniele Amparore, Gabriele Bignante, Enrico Checcucci, Roberto Contieri, Gianluca Spena, Sisto Perdonà, Lin Lin, Vitaly Margulis, Philipp Korn, Nirmish Singla, Melinda Fu, Saum Ghodoussipour, Andrea Minervini, Andrea Mari, Luca Lambertini, Omri Falik Nativ, Mark L Gonzalgo, Daniel A Sidhom, Chandru P Sundaram, Alec Zhu, Reza Mehrazin, Takashi Matsumoto, Masaki Shiota, Takashi Yoshida, Hidefumi Kinoshita, Alireza Deghanmanshadi, Soroush Rais-Bahrami, Hooman Ebrahimi, Hooman Djaladat, Karim Daher, Riccardo Autorino, Riccardo Bertolo, Alessandro Antonelli |
| 発行年月 | 2026/06 |
| 概要 | PURPOSE:To define the incidence and predictors of metachronous contralateral recurrence in upper tract urothelial carcinoma and develop a risk score for tailored surveillance.MATERIALS AND METHODS:We analyzed 3024 patients surgically treated with curative intent from a multi-institutional registry (ROBUUST 3.0). A composite risk score assigned one point each for prior bladder cancer, tumor multifocality, and estimated glomerular filtration rate at discharge <60 mL/min/1.73m2. Patients were stratified into low- (0 points), intermediate- (1-2 points), and high-risk (3 points). Cumulative incidence was estimated using competing risks regression models, accounting for death and distant metastasis, and internally validated using a cause-specific proportional hazards model.RESULTS:Twenty patients (0.7%) developed contralateral recurrence over a median 26.5 months. Recurrence was significantly associated with prior bladder cancer (80% versus 31.5%, p<0.001), tumor multifocality (55% versus 20%, p=0.001), and lower estimated glomerular filtration rate at discharge (39 mL/min/1.73m2 versus 48 mL/min/1.73m2, p=0.01). Three-year cumulative incidence rates were 0.7% (low-risk), 0.9% (intermediate-risk), and 10.5% (high-risk) (p<0.001). High-risk patients faced an estimated 17-fold increased hazard versus low-risk patients. The model demonstrated excellent discriminative accuracy (Concordance Index 0.81).CONCLUSIONS:Contralateral recurrence is rare but heavily dependent on prior bladder cancer, multifocality, and impaired renal function. Our internally validated risk score accurately stratifies patients, facilitating surveillance de-escalation for low-risk individuals and intensive monitoring for high-risk patients. |
| DOI | 10.1097/UPJ.0000000000001042 |
| PMID | 42329063 |