{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T14:38:05Z","timestamp":1786545485893,"version":"build-2736575974"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the risk and timing of metachronous upper tract urothelial carcinoma (UTUC) after non\u2010muscle\u2010invasive bladder cancer (NMIBC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>In this multi\u2010institutional 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\u2010cause mortality as a competing risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 3003 patients, 1158 (39%) were low\u2010risk, 650 (22%) intermediate\u2010risk, 944 (31%) high\u2010risk, and 251 (8%) very high\u2010risk. During a median (interquartile range) follow\u2010up of 4.9\u2009(2.7\u20138.4)\u2009years, 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\u20132.80;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.003). The 10\u2010year cumulative incidence was 2.2% for low\u2010risk, 4.4% for intermediate\u2010risk, and 6.3% for high\u2010 and very high\u2010risk patients. Routine imaging detected UTUC in 40% of low\u2010risk, 58% of intermediate\u2010risk, and 53% of high\u2010 and very high\u2010risk patients. High\u2010grade UTUC was found in 36% of low\u2010risk, 63% of intermediate\u2010risk, and 64% of high\u2010 and very high\u2010risk patients. The majority of UTUC cases (77%) occurred within 5\u2009years of NMIBC.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The contemporary risk of metachronous UTUC may be lower than historical data. Our findings demonstrate that UTUC incidence is low in patients with low\u2010 and intermediate\u2010risk NMIBC and increases in the high\u2010 and very high\u2010risk groups. These results support current guideline recommendations to omit routine upper tract imaging in low\u2010risk NMIBC and question its utility in intermediate\u2010risk disease. In high\u2010risk patients, routine imaging remains warranted, although the optimal frequency and duration are yet to be determined.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.70085","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T01:53:33Z","timestamp":1763603613000},"page":"502-508","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Risk of metachronous upper tract urothelial carcinoma following non\u2010muscle\u2010invasive bladder cancer"],"prefix":"10.1111","volume":"137","author":[{"given":"Keiran J.C.","family":"Pace","sequence":"first","affiliation":[{"name":"Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4728-1025","authenticated-orcid":false,"given":"Jethro C.C.","family":"Kwong","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery University of Toronto  Toronto Ontario Canada"},{"name":"Division of Urology, Department of Surgery University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harkanwal","family":"Randhawa","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery University of Toronto  Toronto Ontario Canada"},{"name":"Division of Urology, Department of Surgery University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximiliano","family":"Ringa","sequence":"additional","affiliation":[{"name":"Institute for Better Health Trillium Health Partners  Mississauga Ontario Canada"},{"name":"Division of Urology, Department of Surgery Trillium Health Partners  Mississauga Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zizo","family":"Al\u2010Daqqaq","sequence":"additional","affiliation":[{"name":"Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yashan","family":"Chelliahpillai","sequence":"additional","affiliation":[{"name":"Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soomin","family":"Lee","sequence":"additional","affiliation":[{"name":"Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4682-6409","authenticated-orcid":false,"given":"Kellie","family":"Kim","sequence":"additional","affiliation":[{"name":"Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Haile","sequence":"additional","affiliation":[{"name":"Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amna","family":"Ali","sequence":"additional","affiliation":[{"name":"Institute for Better Health Trillium Health Partners  Mississauga Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marian","family":"Wettstein","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery University of Toronto  Toronto Ontario Canada"},{"name":"Division of Urology, Department of Surgery University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Chan","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery Mount Sinai Hospital, Sinai Health System  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Perlis","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery University of Toronto  Toronto Ontario Canada"},{"name":"Division of Urology, Department of Surgery University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery University of Toronto  Toronto Ontario Canada"},{"name":"Division of Urology, Department of Surgery University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Hamilton","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery University of Toronto  Toronto Ontario Canada"},{"name":"Division of Urology, Department of Surgery University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Fleshner","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery University of Toronto  Toronto Ontario Canada"},{"name":"Division of Urology, Department of Surgery University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Finelli","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery University of Toronto  Toronto Ontario Canada"},{"name":"Division of Urology, Department of Surgery University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munir","family":"Jamal","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery University of Toronto  Toronto Ontario Canada"},{"name":"Division of Urology, Department of Surgery Trillium Health Partners  Mississauga Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Papanikolaou","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery University of Toronto  Toronto Ontario Canada"},{"name":"Division of Urology, Department of Surgery Trillium Health Partners  Mississauga Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Short","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery University of Toronto  Toronto Ontario Canada"},{"name":"Division of Urology, Department of Surgery Trillium Health Partners  Mississauga Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Feifer","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery University of Toronto  Toronto Ontario Canada"},{"name":"Division of Urology, Department of Surgery Trillium Health Partners  Mississauga Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Girish","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery University of Toronto  Toronto Ontario Canada"},{"name":"Division of Urology, Department of Surgery University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre R.","family":"Zlotta","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery University of Toronto  Toronto Ontario Canada"},{"name":"Division of Urology, Department of Surgery University Health Network  Toronto Ontario Canada"},{"name":"Division of Urology, Department of Surgery Mount Sinai Hospital, Sinai Health System  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,19]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.5489\/cuaj.7487"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21763"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.3800"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2014.01.006"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)67137-6"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-4295(99)00002-3"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1998.16.3.1099"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(01)65570-8"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2018.02.009"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2016.07.063"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15072002"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0090-4295(93)90329-9"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2008.10.168"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.1642"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000003846"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2021.08.010"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14225586"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2023.03.013"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2020.12.033"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2020.06.013"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrurol.2016.165"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1040-8428(03)00079-9"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)00071-6"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000002074.14"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)67707-5"},{"key":"e_1_2_8_27_1","volume-title":"Bladder Cancer: Diagnosis and Management","author":"National Collaborating Centre for Cancer UK","year":"2015"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2013.05.020"}],"container-title":["BJU International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bju.70085","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/bju.70085","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bju.70085","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T11:57:48Z","timestamp":1773316668000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/10.1111\/bju.70085"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,19]]},"references-count":27,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1111\/bju.70085"],"URL":"https:\/\/doi.org\/10.1111\/bju.70085","archive":["Portico"],"relation":{},"ISSN":["1464-4096","1464-410X"],"issn-type":[{"value":"1464-4096","type":"print"},{"value":"1464-410X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,19]]},"assertion":[{"value":"2025-11-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}