Poster, Podium & Video Sessions
Presentation Authors: Seiji Asai*, Ousuke Arai, Terutaka Noda, Tetsuya Fukumoto, Noriyoshi Miura, Yutaka Yanagihara, Yuki Miyauchi, Masao Miyagawa, Tadahiko Kikugawa, Takashi Saika, Toon, Japan
Introduction: Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is useful for detecting of primary lesion and metastasis in patients with upper urinary tract urothelial carcinoma (UTUC). However, there is no study about ipsilateral hydronephrosis on FDG-PET/CT in patients with UTUC. We aimed to evaluate the value of our classification of hydronephrosis on FDG-PET/CT to predict postoperative renal function and pathological outcomes.
Methods: We retrospectively reviewed patients treated with nephroureterectomy (NU) for UTUC at our institution from 2010 to 2016. Among them, 71 patients were examined by FDG-PET/CT before NU. Patients treated with ureteral stent or nephrostomy at the time of FDG-PET/CT scan were excluded, leaving 64 patients for analysis. We classified the hydronephrosis on FDG-PET/CT based on the renal FDG excretion as follows: type0 : no hydronephrosis ; type1 : hydronephrosis with FDG accumulation ; type2 : hydronephrosis without FDG accumulation. Estimated glomerular filtration rate (eGFR [ml/min/1.73m2]) was calculated before the treatment and at early (within 1 month) and late (3-6 months) time points after NU. The change of eGFR was calculated at early time point after NU compared to pretreatment eGFR. The renal dysfunction event, defined as new-onset stage3 chronic kidney disease (CKD) or worsening of CKD stage, was evaluated at late time point after NU compared to pretreatment eGFR. SPSS was used for statistical analysis.
Results: The patients of type 0, 1, 2 were 30 (47%), 18 (28%) and 16 (25%), respectively. The median change of eGFR in type 0, 1, 2 was -23.9, -19.4 and 2.4 ml/min/1.73m2, respectively. The renal dysfunction event rate was the lowest in type2 group (86, 63 vs 19%). On multivariate analysis, classification of hydronephrosis and preoperative eGFR were associated with renal dysfunction event (p<0.05). Furthermore, type2 hydronephrosis was significantly associated with pahological grade3, LVI+ , ≥pT2 (muscle invasive cancer) and pN+ (p<0.05). On multivariate analysis, type2 hydronephrosis was associated with muscle invasive UTUC (p<0.05).
Conclusions: We classified the hydronephrosis based on renal FDG excretion. The classification of pretreatment hydronephrosis on FDG-PET/CT is simple and useful for predicting postoperative renal function and worse pathological outcomes in patients with UTUC.
Source Of Funding: none
Ehime university graduate school of medicine
Dr. Seiji Asai, Department of Urology, Ehime University Graduate School of Medicine, Japanese General Clinical Oncologist, Japanese Board Certified Urologist
2006-2007 Urologist,Department of Urology,Ehime University School of Medicine,Ehime,Japan
2007-2009 Urologist,Department of Urology,Uwajima City Hospital,Ehime,Japan
2009-2010 Urologist,Department of Urology,Shikoku Cancer Center,Ehime,Japan
2010-2013 Urologist,Department of Urology,Kurashiki Central hospital,Okayama,Japan
2013- Urologist,Department of Urology,Ehime University Graduate School of Medicine,Ehime,Japan