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Non-Moderated Poster Abstract

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Abstract

Abstract Title

Regional variations in eligibility for adjuvant immunotherapy among urothelial carcinoma patients undergoing radical surgery: Findings from a multicenter cohort study

Presentation Type

Non-Moderated Poster Abstract

Manuscript Type

Clinical Research

Abstract Category *

Oncology: Bladder and UTUC

Author's Information

Number of Authors (including submitting/presenting author) *

No more than 10 authors can be listed (as per the Good Publication Practice (GPP) Guidelines).
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Co-author 1

Fumihiko Urabe furabe0809@gmail.com The Jikei University School of Medicine Urology Tokyo Japan *

Co-author 2

Juria Nakano jurianakano10@gmail.com The Jikei University School of Medicine Urology Tokyo Japan -

Co-author 3

Takahiro Kimura tkimura0809@gmail.com The Jikei Univeristy School of Medicine Urology Tokyo Japan -

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Abstract Content

Introduction

The CheckMate 274 trial showed improved disease-free survival for advanced urothelial carcinoma (UC) patients receiving adjuvant nivolumab post-radical surgery. However, site-specific differences in outcomes between bladder (UCB) and upper tract urothelial carcinoma (UTUC) are not well studied. This research evaluates oncological outcomes and eligibility for adjuvant immunotherapy in UCB and UTUC patients undergoing radical surgery.

Materials and Methods

We retrospectively analyzed 719 UC patients who underwent radical surgery. Patients were divided into two groups: candidates for adjuvant immunotherapy (pT3–4/pN+ or ypT2–4/ypN+ with NAC) and non-candidates. Kaplan-Meier curves assessed non-urothelial tract recurrence-free survival (NUTRFS), cancer-specific survival (CSS), and overall survival (OS). Cox regression analysis identified risk factors.

Results

Potential adjuvant immunotherapy candidates had significantly worse NUTRFS, CSS, and OS than non-candidates, in both UCB and UTUC groups. However, no significant differences in NUTRFS, CSS, or OS were found between UCB and UTUC within adjuvant immunotherapy candidates. Trends were similar among patients ineligible for adjuvant immunotherapy. Pathological T stage, N stage, and lymphovascular invasion (LVI) were independent predictors of oncological outcomes.

Conclusions

The CheckMate 274 criteria effectively stratify UC patients after surgery. LVI, alongside T and N stages, should be considered when selecting adjuvant immunotherapy candidates, underscoring its importance in treatment decisions.

Keywords

UTUC, CheckMate 274 trial, lymphovascular invasion, JIKEI-YAYOI cohort

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Presentation Order