The Society of Urologic Oncology (SUO) held its 2025 Annual Meeting on December 3–5, 2025, in Phoenix, Arizona. The conference gave researchers, physicians, and members of industry the opportunity to share and learn about the latest research in bladder cancer. The event included speaker presentations on various clinical topics in bladder cancer, as well as posters reporting the latest data on bladder cancer treatment options. Summaries of key abstracts from the meeting are included here.
Germline variations in bladder cancer by age: whole-genome sequencing of a diverse United States cohort. Currently, potential age-related germline differences in bladder cancer are unknown; as such, researchers conducted a genome-wide association study (GWAS) to identify age-related germline variants in patients with bladder cancer, focusing on younger patients (<60 years of age). Data from the National Institutes of Health All of Us research program were utilized, with 1,312 older patients (≥60 years of age) and 243 younger patients included for genetic analysis. Additionally, 2020 to 2021 Surveillance, Epidemiology, and End Results (SEER) data was assessed for tumor grade and stage, stratified by age at diagnosis (≥60 years: n=19,760; 22–59 years: n=3,645). One single-nucleotide polymorphism (SNP) on chromosome 2 (chr2:53580249) reached significance in the younger patient group (P=8.5e–9), and it was mapped to ASB3. However, this was a noncoding region, and there was no significant tissue-specific gene expression. In the older patient cohort, a SNP on chromosome 19 (chr19:16035388) reached significance (P=3.2e–8), which mapped to PRKCH. Three SNPs on chromosome 7 reached significance (P=1.6e–8, 1.6e–8, and 3.1e–8), mapping to CHRM2. Both PRKCH and CHRM2 were found to be upregulated in bladder tissue, and both genes have been associated with tumorigenesis pathways. SEER data reflected age-related germline differences, with older patients having higher odds of high-grade and invasive tumors compared to younger patients (both P<0.001).
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Preoperative hemoglobin A1c levels as predictor of major complication after radical cystectomy. In this retrospective cohort study, researchers assessed the association between preoperative hemoglobin A1c (HbA1c) levels and 30-day high-grade complications among patients who underwent radical cystectomy (RC) for bladder cancer. Data from 2018 to 2024 were utilized. High-grade complications were defined as Clavien-Dindo grade ≥3, and HbA1c was classified as no diabetes (≤5.6%), prediabetes (5.7–6.4%), and diabetes (≥6.5%). The total sample consisted of 361 patients, with 151 in the no diabetes group, 116 in the prediabetes group, and 94 in the diabetes group. High-grade complications were reported in 101 patients (28%). There was no significant difference in the likelihood of high-grade complications between the no diabetes group and the prediabetes or diabetes groups. When assessing HbA1c as a continuous variable, there was no association between HbA1c and high-grade complications (adjusted odds ratio [aOR]: 1.1; 95% confidence interval [CI]: 0.86–1.42). Current/former smoking status (aOR: 2.6; 95% CI: 1.32–5.12; P= 0.006), pT3 (aOR: 2.17; 95% CI: 1.10–4.29; P= 0.025), and pT4 (aOR: 3.81; 95% CI: 1.33–10.9; P= 0.013) were significantly associated with high-grade complications. Multivariable analysis showed a significant association between increasing HbA1c and infectious complications (aOR: 1.24; 95% CI: 1.01–1.51; P= 0.04).
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Chromosome 9p21 deletions frequently co-occur in FGFR3-mutant non-muscle invasive bladder cancer (NMIBC) and correlate with poor clinical outcomes. Although FGFR3 alterations are associated with lower tumor grade and stage in NMIBC, concurrent CDKN2A deletion is common and confers greater risk of disease recurrence and progression. In this study, researchers assessed co-alterations in FGFR3-altered CDKN2A-deleted NMIBC and examined the prognostic impact of chromosome 9p21 loss. Among 503 patients with NMIBC, 195 harbored FGFR3 alteration alone and 63 harbored concurrent FGFR3 alteration and CDKN2A deletion. Median follow-up was 47 months. Clinicopathologic characteristics were similar between groups. Recurrence-free survival (RFS; 13 vs. 52 months; hazard ratio [HR]: 1.84; 95% CI: 1.18–2.86; P= 0.002) and high-grade RFS (40 vs. 190 months; HR: 1.77; 95% CI: 1.02–3.06; P= 0.02) were significantly decreased in patients with FGFR3 alteration alone versus those with concurrent FGFR3/CDKN2A alteration. Deletions in CDKN2B and MTAP, two chromosome 9p21 genes, were observed in 95.2% and 71.4% of tumors with concurrent FGFR3/CDKN2A alterations, respectively, compared to 0% each for tumors with FGFR3 alterations alone (P=1.0×10–10 and 7.6×10–6, respectively). While there was a trend toward shorter RFS with increasing chromosome 9p21 deletion (log-rank P= 0.15), progression-free survival was significantly worse with concurrent CDKN2A/CDKN2B/MTAP deletion (HR: 5.6; 95% CI: 1.34–23.3; P= 0.02).
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Characteristics and survival outcomes of metastatic non-muscle invasive bladder cancer in comparison with metastatic muscle invasive bladder cancer: insights from the National Cancer Database. Researchers compared characteristics and outcomes among patients with non-muscle invasive bladder cancer (NMIBC) and MIBC with metastases. In both the NMIBC (n=3,982) and MIBC (n=18,450) groups, bone was the most common site of metastasis, followed by lungs, liver, and brain. Multiple metastases were present in 15.1% of patients with NMIBC and 13.5% with MIBC. Median overall survival (OS) was longer in the metastatic NMIBC group vs the metastatic MIBC group (6.54 [6.04–7.03] vs 6.24 [6.08–6.39] months; P< 0.001). In both groups, patients with multiple sites of metastases experienced shorter median OS compared to other isolated metastases (NMIBC: 3.55 [3.05–4.04]; MIBC: 4.04 [3.78–4.29]; P< 0.001). When stratifying patients based on site of metastasis, among patients with NMIBC, median OS was longest in those with lung metastasis (8.48 [6.68–10.27] months) and shortest in those with liver metastasis (3.70 [2.80–5.59] months); in the MIBC group, median OS was longest in patients with bone metastasis (6.90 [6.45–7.35] months) and shortest in those with brain metastasis (5.13 [4.03–6.23] months).
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Survival outcomes of a smoking cessation treatment program after diagnosis of bladder cancer. Researchers analyzed data from the Tobacco Research and Treatment Program (TRTP) to determine the impact of smoking cessation on OS following urothelial bladder cancer diagnosis. Patients with urothelial bladder cancer enrolled in the TRTP between 2006 to 2022 were eligible for inclusion. Among 169 patients, median age was 60 years, and most patients were male (74.6%) and White (87.6%). Heavy smoking was prevalent, with a median of 50 pack-years. Less than half of patients ceased smoking; at 3-, 6-, and 9-month follow-up appointments, the rate of smoking abstinence was 43%, 44%, and 38%, respectively. Patients who had ceased smoking at 9 months had a median OS of 14.5 years, whereas patients who continued smoking had a median OS of 10.7 years; this difference was significant (P=0.014). Upon adjusted analysis, OS was significantly improved with smoking cessation at 6 and 9 months. Furthermore, smoking abstinence at any timepoint was associated with significantly improved cancer-specific survival, RFS, and metastasis-free survival, compared to nonabstinence.
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Actionable genomic alterations in non-muscle invasive bladder cancer are conserved across tumor recurrences. In this study, researchers assessed the concordance of genomic alterations among patients with NMIBC who experience disease recurrence. Eligible patients underwent transurethral resection of bladder tumor (TURBT) and had at least 2 bladder cancer samples that underwent tumor and germline sequencing. Thirty-eight patients, 82% of whom were male, were included for analysis. Most patients (50%) had high-grade Ta disease, followed by high-grade T1 (37%) and carcinoma in situ alone (13%) at index TURBT. Median time from index TURBT to first recurrence was 12 months. After index TURBT, 68% of patients were treated with intravesical therapy and 11% underwent RC, with 21% of patients not receiving further therapy. TERT mutations were the most common across all specimens, present in 71%; other frequent mutations included KDM6A (50%), FGFR3 (45%), ARID1A (40%), and KMT2D (32%). There was high concordance in genetic mutations, including actionable mutations, between index and subsequent tumor specimens; for example, concordance was 88% for FGFR3, 80% for ERBB2, 78% for PIK3CA, and 75% for TSC1.
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