Abstracts from the Mid-Atlantic Section of the AUA 2020

© The Canadian Journal of Urology TM : International Supplement, October 2020 Risk Factors for Intravesical Recurrence of Non-Muscle Invasive Bladder Cancer in an Untreated Cohort A. Charap Icahn School of Medicine at Mount Sinai, New York, NY, USA Introduction: Identifying risk-factors associated with increased risk of recurrence is important for risk-stratifying patients with non-muscle invasive bladder cancer (NMIBC). Previous studies have identified variables such as tumor diameter, grade, andmultifocal disease as being associated with increased risk of recurrence, however these studies included both treated and untreated patients. We aimed to identify risk-factors for recurrence in an untreated cohort of patients in order to improve risk-stratification of patients with NMIBC. Materials &Methods: Our population consisted of NMIBC patients in Stockholm County diagnosed between 1995-96. We excluded participants who received intravesical therapy, chemotherapy, or radiation after initial TURBT. We identified 254 patients whomet inclusion criteria. We performed amultivariate Cox regression analysis using four common recurrence predictors. Results: The median age of the cohort at diagnosis was 73 years. 173 (68%) were men, 222 (87%) had pathologic Ta disease, and 68 (26%) of primary tumors were high-grade. 137 (54%) patients had an intravesical recurrence during the median follow-up period of 10.3 years. Median time to first recurrence was 10 months. Both tumor diameter > 3 cm (HR 2.1, 95% CI 1.3 – 3.2) and multifocal disease (HR 2.2, 95% CI 1.5 – 3.3) were associated with greater risk of intravesical recurrence. Stage T1 (HR 1.0, 95%CI .55 – 1.9) and high-grade disease (HR 1.0, 95%CI .63 – 1.6) were not significantly associated with increased risk of recurrence in our cohort. Conclusions: Of four variables commonly cited as predictors for recurrence, only tumor diameter greater than 3 centimeters and multifocal disease were associated with greater hazard for recurrence in an untreated cohort. Unlike in previous studies, higher grade and stage were not associated with increased risk of recurrence. MP6-07 Revisits After Ambulatory TURBT: Facility and Provider Characteristics K. Michel; T. Guzzo; J. Ziemba Hospital of the University of Pennsylvania, Philadelphia, PA, USA Introduction: Previous studies using national data suggest transurethral resection of bladder tumor (TURBT) has a readmission rate ranging from 3-11%. However these papers are limited in their granularity, in particular with regard to facility or provider characteristics, which have been shown to impact revisit rates following other urologic procedures. Materials &Methods: We identified index TURBT cases from the Healthcare Cost and Utilization Project’s (HCUP) StateAmbulatory Surgery and Services Database (SASD), a state-wide, all-payor, event-level database. We filtered for primary CPT codes 52234, 52235, or 52240 from 2010-2014 in two states, New York (NY) and Florida (FL). Revisit rate was calculated as return to either emergency department (ED) or inpatient (IP) within 30 days. Revisits were analyzed by facility ownership (hospital owned vs. freestanding), facility volume, and provider volume. Facility and provider volume were analyzed by quartiles based on procedure volume. Results: The overall revisit rate for ambulatory TURBT was 6.6%. Table 1 shows the revisit rates broken down by revisit type and facility ownership. Inmultivariate regression adjusting for age, sex, race, chronic conditions, income, insurance status, and urban-rural location, freestanding status remained a significant predictor of lower odds of revisit (OR 0.83, p < 0.01, 95%CI: 0.76-0.90). Table 2 shows revisit rates stratified by provider and facility volume quartiles. Conclusions: Ambulatory TURBTs performed in freestanding facilities have lower odds of revisit after adjusting for patient demographics. Increased provider volume, but not facility volume, may decrease revisit rates. MP6-06 Poster Session 6: Urologic Oncologic Disease 42