Hypertension Tied to Worse Survival After Surgery for Upper Tract Urothelial Cancers

Hypertension was found to be an independent risk factor for worse survival outcomes in patients with upper tract urothelial cancer undergoing radical nephroureterectomy, according to data presented at the recent American Urological Association annual meeting.

In this video, Katie S. Murray, DO, associate professor of urology at NYU Langone Health and chief of urology at Bellevue Hospital, both in New York City, describes the analysis of the ROBUUST (Robotic Surgery for Upper Tract Urothelial Cancer Study) registry.

Following is a transcript of her remarks:

We all treat urologic patients, and comorbidities is a very important thing that we talk about and how those comorbidities can be predictive or worrisome for outcomes in our oncologic patients. So this study is actually looking at the diagnosis of patients with hypertension and what kind of impact does that have on patients for overall survival, specifically in patients undergoing nephroureterectomy for upper tract urothelial carcinoma.

So we know that hypertension is impactful on a person's overall quality of life. But specifically is there any impact of that on the oncologic outcomes, specifically of upper tract disease?

So the researchers in this study used what's called the ROBUUST database. It's a multi-institutional study looking at patients undergoing robotic nephroureterectomy for upper tract disease. They looked at 865 patients retrospectively, 488 of those had baseline hypertension and 377 without. So those are the two cohorts that we're going to compare directly in this study.

They had a median follow-up of about 30 months for this cohort of patients undergoing nephroureterectomy. And for the most part, those from an age standpoint and other patient characteristics, they were fairly similar. There was a difference in high-grade disease in those with the hypertension being 79% compared to 70% who did not have high-grade disease pathologically.

But on multivariate analysis, I think what's important is that hypertension, or the diagnosis of hypertension, was an independent factor for all-cause mortality as well as cancer-specific mortality and cancer recurrence rates. And so not just from life and the impact of hypertension, but where does that diagnosis of hypertension and the subsequent treatments that come, and what does that mean for this particular cancer population? So those patients who had hypertension had a decreased overall survival of those undergoing radical nephroureterectomy of 67% versus 80%.

And so I think this is interesting. It's a big group of patients that are looked at retrospectively. It's an operation and a disease that we see as urologic oncologists and urologists quite commonly. And hypertension is very common. And so there's definitely more to be studied here and exciting to see where this takes us.

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