Mp47-04 hypertension is associated with worsened oncological survival outcomes in patients undergoing nephroureterectomy for upper tract urothelial carcinoma: analysis of the robuust registry

You have accessJournal of UrologyCME1 Apr 2023MP47-04 HYPERTENSION IS ASSOCIATED WITH WORSENED ONCOLOGICAL SURVIVAL OUTCOMES IN PATIENTS UNDERGOING NEPHROURETERECTOMY FOR UPPER TRACT UROTHELIAL CARCINOMA: ANALYSIS OF THE ROBUUST REGISTRY Sohail Dhanji, Franklin Liu, Kevin Hakimi, Hooman Djaladat, Firas Abdollah, Mark L. Gonzalgo, Linhui Wang, Matteo Ferro, Courtney Yong, Jacob Taylor, Savio D. Pandolfo, Francesco Porpiglia, Enrico Checcucci, Benjamin M. Eilender, Daniel D. Eun, Spencer H. Bell, Erika Wood, Alireza Ghoreifi, Matthew Davis, Alex Stephens, Gabriele Tuderti, Dinno F. Mendiola, Marco Tozzi, Riccardo Autorino, Chandru P. Sundaram, Reza Mehrazin, Vitaly Margulis, Giuseppe Simone, Zhenjie Wu, and Ithaar Derweesh Sohail DhanjiSohail Dhanji More articles by this author , Franklin LiuFranklin Liu More articles by this author , Kevin HakimiKevin Hakimi More articles by this author , Hooman DjaladatHooman Djaladat More articles by this author , Firas AbdollahFiras Abdollah More articles by this author , Mark L. GonzalgoMark L. Gonzalgo More articles by this author , Linhui WangLinhui Wang More articles by this author , Matteo FerroMatteo Ferro More articles by this author , Courtney YongCourtney Yong More articles by this author , Jacob TaylorJacob Taylor More articles by this author , Savio D. PandolfoSavio D. Pandolfo More articles by this author , Francesco PorpigliaFrancesco Porpiglia More articles by this author , Enrico CheccucciEnrico Checcucci More articles by this author , Benjamin M. EilenderBenjamin M. Eilender More articles by this author , Daniel D. EunDaniel D. Eun More articles by this author , Spencer H. BellSpencer H. Bell More articles by this author , Erika WoodErika Wood More articles by this author , Alireza GhoreifiAlireza Ghoreifi More articles by this author , Matthew DavisMatthew Davis More articles by this author , Alex StephensAlex Stephens More articles by this author , Gabriele TudertiGabriele Tuderti More articles by this author , Dinno F. MendiolaDinno F. Mendiola More articles by this author , Marco TozziMarco Tozzi More articles by this author , Riccardo AutorinoRiccardo Autorino More articles by this author , Chandru P. SundaramChandru P. Sundaram More articles by this author , Reza MehrazinReza Mehrazin More articles by this author , Vitaly MargulisVitaly Margulis More articles by this author , Giuseppe SimoneGiuseppe Simone More articles by this author , Zhenjie WuZhenjie Wu More articles by this author , and Ithaar DerweeshIthaar Derweesh More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003293.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Impact of hypertension (HTN) on oncologic outcomes in upper tract urothelial carcinoma (UTUC) is uncertain with emerging reports suggesting risk with respect to intravesical recurrence after Radical Nephroureterectomy (RNU). We sought to analyze the impact of HTN on UTUC outcomes in a contemporary cohort of patients who underwent RNU. METHODS: We performed a multi-center retrospective analysis of patients who underwent RNU for UTUC utilizing the ROBUUST (ROBotic surgery for Upper tract Urothelial cancer STudy) database. Primary outcome was all-cause mortality (ACM); secondary outcomes were cancer-specific mortality (CSM) and recurrence. The cohort was divided into groups based on hypertension status for analyses. Multivariable cox regression analyses were conducted to elucidate predictors for outcomes, and Kaplan-Meier analyses (KMA) were performed to analyze for overall (OS), cancer-specific (CSS) and recurrence-free survival (RFS) stratified by HTN status. RESULTS: We analyzed 865 patients (488 with hypertension/377 without hypertension; mean follow up 30.5 months). Comparing patients with hypertension versus those without, there was no significant difference in percentage of male gender (59.8% vs 59.2%, p=0.839), mean age (72.12 vs 68.57, p=0.086), tumor size (3.8 vs. 4.0 cm, p=0.425) or positive margin rate (5.3% vs 4.8%, p=0.713) between the cohorts, while patients with hypertension had a significantly greater rate of high tumor grade (78.5% vs 69.5%, p=0.005). Multivariable analysis demonstrated hypertension to be an independent risk factor for worsened ACM (HR 1.83, p=0.013, CSM (HR 2.41, p=0.010) and recurrence (HR 1.41, p=0.022). KMA comparing patients with hypertension versus patients without hypertension, revealed significantly lower 3-year OS (66.9% vs 79.8%, p=0.003), 3-year CSS (77.2% vs 87.5%, p=0.030), and 3-year PFS (48.8% vs. 60.6%, p=0.032) for patients with hypertension. CONCLUSIONS: Hypertension is an independent risk factor for worsened oncologic and survival outcomes in patients undergoing RNU for UTUC. Further investigation is warranted to confirm these findings and elucidate mechanisms of action and explore strategies to improve outcomes with improved control of hypertension. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e644 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sohail Dhanji More articles by this author Franklin Liu More articles by this author Kevin Hakimi More articles by this author Hooman Djaladat More articles by this author Firas Abdollah More articles by this author Mark L. Gonzalgo More articles by this author Linhui Wang More articles by this author Matteo Ferro More articles by this author Courtney Yong More articles by this author Jacob Taylor More articles by this author Savio D. Pandolfo More articles by this author Francesco Porpiglia More articles by this author Enrico Checcucci More articles by this author Benjamin M. Eilender More articles by this author Daniel D. Eun More articles by this author Spencer H. Bell More articles by this author Erika Wood More articles by this author Alireza Ghoreifi More articles by this author Matthew Davis More articles by this author Alex Stephens More articles by this author Gabriele Tuderti More articles by this author Dinno F. Mendiola More articles by this author Marco Tozzi More articles by this author Riccardo Autorino More articles by this author Chandru P. Sundaram More articles by this author Reza Mehrazin More articles by this author Vitaly Margulis More articles by this author Giuseppe Simone More articles by this author Zhenjie Wu More articles by this author Ithaar Derweesh More articles by this author Expand All Advertisement PDF downloadLoading ...