Outcomes and prognostic factors in patients with synchronous and metachronous oligometastatic urothelial carcinoma with visceral metastases

Author:

Yoshida Soichiro1,Maezawa Yuya2,Ishihara Kensaku3,Inoue Naoki4,Tanabe Kenji5,Izumi Keita6ORCID,Fujiwara Motohiro1ORCID,Toide Masahiro7ORCID,Yamamoto Takanobu8,Uehara Sho9,Araki Saori10,Inoue Masaharu11ORCID,Takazawa Ryoji12ORCID,Numao Noboru13,Ohtsuka Yukihiro14,Tanaka Hajime1ORCID,Fujii Yasuhisa1ORCID

Affiliation:

1. Department of Urology Tokyo Medical and Dental University Bunkyo‐ku Tokyo Japan

2. Department of Urology Tsuchiura Kyodo General Hospital Tsuchiura‐shi Ibaraki Japan

3. Department of Urology Soka Municipal Hospital Soka‐shi Saitama Japan

4. Department of Urology JA Toride Medical Hospital Toride‐shi Ibaraki Japan

5. Department of Urology Saitama Red Cross Hospital Saitama Japan

6. Department of Urology Dokkyo Medical University Saitama Medical Center Koshigaya‐shi Saitama Japan

7. Department of Urology Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital Bunkyo‐ku Tokyo Japan

8. Department of Urology Tokyo Metropolitan Tama‐Nambu Chiiki Hospital Tama‐shi Tokyo Japan

9. Department of Urology Showa General Hospital Kodaira‐shi Tokyo Japan

10. Department of Urology Kohnodai Hospital Ichikawa‐shi Chiba Japan

11. Department of Urology Saitama Prefectural Cancer Center Kitaadachi‐gun‐Ina‐machi Saitama Japan

12. Department of Urology Tokyo Metropolitan Ohtsuka Hospital Toshima‐ku Tokyo Japan

13. Department of Urology Cancer Institute Hospital Koto‐ku Tokyo Japan

14. Department of Urology Japanese Red Cross Omori Hospital Ota‐ku Tokyo Japan

Abstract

AbstractObjectivesTo evaluate the clinical characteristics of oligometastatic disease (OMD) in metastatic urothelial carcinoma (mUC) with visceral metastases when classified into synchronous and metachronous metastases.MethodsOf 957 cases of de novo mUC treated between 2008 and 2023, 374 with visceral metastases were analyzed. Cases were classified into OMD with up to three metastatic lesions and polymetastatic disease (PMD), and into synchronous and metachronous metastases. The clinical characteristics and overall survival (OS) for each group were analyzed.ResultsOverall, 196 (52.4%) had synchronous metastasis and 178 (47.6%) had metachronous metastasis. Median OS for synchronous metastases was significantly shorter than for metachronous metastases (12.1 months vs. 15.3 months, p = 0.011). Among the synchronous metastases, 48 (24.5%) were OMD and 148 (75.6%) were PMD. There was no significant difference in OS between the OMDs and PMDs (median 14.9 months vs. 11.7 months, p = 0.32), and only decreased albumin level was identified as a significant predictor of poor OS. Among the metachronous metastases, 64 (36.0%) were OMD and 114 (64.0%) were PMD. There was no significant difference in OS between the OMD and PMD (median 21.2 months vs. 15.0 months, p = 0.35), and no significant predictors of poor OS were identified.ConclusionsFor mUC with visceral metastases, the timing of metastasis appearance was associated with prognosis, with synchronous metastases being a poorer prognostic factor compared to metachronous metastases. There was no prognostic difference between OMD and PMD with visceral metastases when classified into synchronous or metachronous metastases.

Publisher

Wiley

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