Supplementary Material for: Retrograde Pyelography in the Presence of Urothelial Bladder Cancer Does Not Affect the Risk of Upper Tract Urothelial Cancer: A Retrospective Analysis of a Single-Centre Cohort

<b><i>Objective:</i></b> Patients with bladder cancer (BC) are at risk of developing upper tract urothelial carcinoma (UTUC). Therefore, CT urography is recommended for follow-up. To avoid intravenous contrast agents, retrograde pyelography (RPG) is an alternative. However, it is still unclear whether RPG increases the incidence of UTUC. The aim of this study was to investigate the impact of RPG in the presence of BC on the risk of developing UTUC. <b><i>Patients and Methods:</i></b> Retrospectively analysing a total of 3,680 RPGs between 2009 and 2016, all patients with simultaneous BC (group 1) and those without synchronous BC (group 2) during RPG were compared. All patients were risk stratified according to the EORTC bladder calculator. In patients without BC during RPG, risk stratification was based on the worst prior tumour characteristics. <b><i>Results:</i></b> A total of 145 patients with a history of BC were analysed. Of these, 112 patients underwent RPG with simultaneous BC. UTUC developed in 6 of 112 patients (5.4%) and 58.9% (66/112) had high-risk BC according to the EORTC bladder calculator. In the control group, one out of 33 (3%) patients with metachronous high-risk BC developed UTUC. <b><i>Conclusions:</i></b> Using RPG in the presence of BC did not increase the risk of UTUC. Due to the predominant number of high-risk/high-grade tumours, individual tumour biology appears to be the primary driver for the development of UTUC.

<b><i>研究目的：</i></b> 膀胱癌（bladder cancer, BC）患者罹患上尿路尿路上皮癌（upper tract urothelial carcinoma, UTUC）的风险较高，因此临床推荐采用CT尿路造影（CT urography）进行随访。为避免使用静脉对比剂（intravenous contrast agents），逆行肾盂造影（retrograde pyelography, RPG）可作为替代方案，但目前尚不明确RPG是否会增加UTUC的发病风险。本研究旨在探讨膀胱癌患者接受RPG对上尿路尿路上皮癌发病风险的影响。
<b><i>患者与方法：</i></b> 本研究回顾性分析了2009年至2016年间共计3680例逆行肾盂造影病例，对比分析造影期间同步合并膀胱癌的患者（组1）与无同步膀胱癌的患者（组2）。所有患者均依据欧洲癌症研究与治疗组织（European Organisation for Research and Treatment of Cancer, EORTC）膀胱癌风险计算器进行风险分层。对于造影时未检出膀胱癌的患者，风险分层基于其既往最严重的肿瘤特征。
<b><i>结果：</i></b> 本研究共计纳入145例有膀胱癌病史的患者进行分析。其中112例患者在接受逆行肾盂造影时同步合并膀胱癌。112例患者中有6例（5.4%）后续发生上尿路尿路上皮癌，且其中58.9%（66/112）经EORTC膀胱癌风险计算器评估为高危膀胱癌。对照组中，33例异时性高危膀胱癌患者中有1例（3%）发生上尿路尿路上皮癌。
<b><i>结论：</i></b> 膀胱癌患者接受RPG并未增加上尿路尿路上皮癌的发病风险。由于高危/高分级肿瘤占比居多，个体肿瘤生物学特性似乎是上尿路尿路上皮癌发生的主要驱动因素。