Dr Dhanji on the Effect of Hypertension on Survival Outcomes in Upper Tract Urothelial Carcinoma

Sohail Dhanji, MD, clinical research fellow, Department of Urology, University of California San Diego School of Medicine, discusses the effect of preoperative hypertension on survival outcomes in patients undergoing nephroureterectomy for upper tract urothelial carcinoma, and the importance of hypertension control in this population.

A multicenter retrospective analysis of 865 patients with upper tract urothelial carcinoma who underwent nephroureterectomy was performed utilizing the ROBotic surgery for Upper tract Urothelial cancer Study (ROBUUST) database. This patient cohort was further divided into those with hypertension (n = 488) and those without (n = 377). The study's primary outcome was all-cause mortality (ACM), and key secondary outcomes were cancer-specific mortality (CSM) and recurrence.

Multivariable cox regression analyses confirmed that hypertension was a significant independent risk factor for ACM, CSM, and recurrence in this patient population, Dhanji says. According to Kaplan-Meier analysis, the 3-year overall survival (OS) rates for patients with and without hypertension were 66.9% and 79.8%, respectively (P = .003). Additionally, 3-year recurrence-free survival was 48.8% in patients with hypertension vs 60.6% in those without hypertension (P = .032). Lastly, the frequency of high tumor grade in patients with hypertension was 78.5% vs 69.5% in those without hypertension (P = .005).

These findings highlight the importance of hypertension management as a strategy to improve survival outcomes for this patient population, Dhanji states. However, it remains to be seen whether these strategies would be most effective if utilized during the initial diagnosis process or after undergoing nephroureterectomy, Dhanji notes. Further research is needed to confirm these findings and explore alternative strategies for hypertension control, Dhanji concludes.