ArticleBJU international2026
Risk of metachronous upper tract urothelial carcinoma following non-muscle-invasive bladder cancer.
Article in BJU international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Percutaneous thermal ablation versus robot-assisted partial nephrectomy for localized renal cell carcinoma: a systematic review and meta-analysis stratified by tumor complexity.Journal of robotic surgery · 2026Pooled it
- When double-J stents become a risk: bilateral distal ureteric urothelial carcinoma following ureteric instrumentation: a case report.BMC urology · 2026Article
- Regulatory T cells in the bladder cancer tumor microenvironment: mechanisms of immune suppression and therapeutic opportunities.Frontiers in molecular biosciences · 2026Review
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Authors and funding
23 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the risk and timing of metachronous upper tract urothelial carcinoma (UTUC) after non-muscle-invasive bladder cancer (NMIBC). PATIENTS AND
methodsIn this multi-institutional retrospective cohort study involving academic and community hospitals, clinicopathological data were collected from patients with NMIBC treated between 2005 and 2022. Patients with prior or synchronous UTUC at NMIBC diagnosis were excluded. The primary outcome was time to metachronous UTUC, confirmed on pathology or upper tract imaging. Secondary objectives included determining the cumulative incidence of UTUC stratified by the European Association of Urology risk groups and UTUC risk factors identified using Fine and Gray regression, with all-cause mortality as a competing risk.
resultsAmong 3003 patients, 1158 (39%) were low-risk, 650 (22%) intermediate-risk, 944 (31%) high-risk, and 251 (8%) very high-risk. During a median (interquartile range) follow-up of 4.9 (2.7-8.4) years, 104 patients developed UTUC. On multivariable analysis, multiple tumours were an independent predictor of UTUC (subdistribution hazard ratio 1.86, 95% confidence interval 1.24-2.80; P = 0.003). The 10-year cumulative incidence was 2.2% for low-risk, 4.4% for intermediate-risk, and 6.3% for high- and very high-risk patients. Routine imaging detected UTUC in 40% of low-risk, 58% of intermediate-risk, and 53% of high- and very high-risk patients. High-grade UTUC was found in 36% of low-risk, 63% of intermediate-risk, and 64% of high- and very high-risk patients. The majority of UTUC cases (77%) occurred within 5 years of NMIBC.
conclusionsThe contemporary risk of metachronous UTUC may be lower than historical data. Our findings demonstrate that UTUC incidence is low in patients with low- and intermediate-risk NMIBC and increases in the high- and very high-risk groups. These results support current guideline recommendations to omit routine upper tract imaging in low-risk NMIBC and question its utility in intermediate-risk disease. In high-risk patients, routine imaging remains warranted, although the optimal frequency and duration are yet to be determined.
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