Metastasis-Directed Radiotherapy for Oligometastatic Urothelial Carcinoma of the Bladder and Upper Tract

Authors

Patrick Carriere
Omar Alhalabi
Jianjun Gao
Amishi Shah
Sangeeta Goswami
Matthew Campbell
Ruitao Lin
Lauren Mayo
Osama Mohamad
Karen Hoffman
Henry Mok
Charmaigne Lozano
Ashish Kamat
Neema Navai
Kelly Bree
Byron Lee
Charles Guo
Michael Rooney
Chad Tang
Seungtaek Choi
Comron Hassanzadeh

Language

English

Publication Date

1-1-2026

Journal

Bladder Cancer

DOI

10.1177/23523735251414249

PMID

41550986

PMCID

PMC12804661

PubMedCentral® Posted Date

1-14-2026

PubMedCentral® Full Text Version

Post-print

Abstract

Background: Metastasis-directed therapy (MDT) for oligometastatic cancer is utilized for genitourinary malignancies including prostate and kidney cancers. Clinical research on MDT for urothelial carcinoma (UC) remains sparse, especially as systemic therapy advances have improved outcomes.

Objective: We investigated the role of MDT, specifically radiotherapy, for patients with oligometastatic bladder or upper-tract UC.

Methods: Data were collated on patients with metastatic UC with 5 or fewer metastatic sites undergoing MDT with ablative radiotherapy with or without preceding systemic therapy during January 2016 to July 2024. Endpoints were progression-free survival (PFS), and overall survival (OS). Cox proportional hazards analysis was conducted to determine the covariates associated with these endpoints.

Results: Fifty-two patients were included. Most were men (67%). Median age was 68 years (interquartile range, 62-78). Most had bladder primary tumors (79%). Patients had a median of 1 metastatic site. Most received ≥2 lines of systemic therapy before MDT (60%), whereas 8% received no systemic therapy before MDT. MDT was delivered to all metastases in 71% of cases, whereas the remaining cases (29%) had MDT delivered to select sites. Median follow-up from the diagnosis of metastasis was 32 months (interquartile range, 23-42). Median PFS and OS were 19 months (95% CI, 15-24) and 42 months (95% CI, 24-60), respectively.

Conclusions: MDT may serve as an effective adjunct to systemic therapy to improve outcomes of oligometastatic and oligoprogressive UC.

Keywords

urothelial carcinoma, bladder cancer, upper tract urothelial carcinoma, metastasis directed therapy, radiation, oligometastatic

Published Open-Access

yes

Recommended Citation

Carriere, Patrick; Alhalabi, Omar; Gao, Jianjun; et al., "Metastasis-Directed Radiotherapy for Oligometastatic Urothelial Carcinoma of the Bladder and Upper Tract" (2026). Faculty, Staff and Student Publications. 5696.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/5696