Evaluating the relationship between vasculitis and metastasis in kidney-related urogenital cancers: A multicenter real-world propensity-matched cohort study

Document Type

Article

Publication Date

3-2026

Abstract

Vasculitis, a disorder with systemic inflammation and immune dysregulation, can create a pro-tumorigenic microenvironment. While its connection with higher cancer incidence is recognized, its specific role in cancer development and metastatic spread remains poorly characterized. This study aims to evaluate whether a pre-existing diagnosis of vasculitis is associated with an increased risk of metastasis in patients with urogenital cancer. Methods: Using the multinational TriNetX database, we conducted a propensity-matched cohort study. Patients with malignant kidney, upper tract, or bladder cancer and a diagnosis of vasculitis were compared to a matched cohort with the same cancers but without vasculitis. A 3-year lookback period was used for comorbidity assessment. The primary outcome was the development of metastasis following the initial cancer diagnosis. By restricting the cohort to non-metastatic cancers at baseline, metastasis was assessed as a subsequent outcome rather than a pre-existing condition. The secondary outcome was all-cause mortality, analyzed using Kaplan-Meier estimates and Cox proportional hazards models. Results: After matching, 2, 222 patients were distributed to both groups. Patients with vasculitis had a significantly higher risk of metastasis than those without vasculitis (Hazard Ratio [HR] 1.68, 95% CI 1.26-2.24, p = 0.032). Survival without metastasis was 81.7% in the vasculitis group compared to 93.9% in the control group. Conversely, the difference in all-cause mortality was not statistically significant (HR 1.04, 95% CI 0.93-1.17, p = 0.050), though survival probabilities at 5 years were much lower in the vasculitis group (27.1% compared to 41.9%). Conclusions: Vasculitis is associated with a significantly higher risk of metastasis in urogenital cancer patients. These findings position vasculitis as a potential marker for aggressive disease. Increased vigilance and targeted management may be warranted for those urogenital cancer patients with accompanying vasculitis to combat this increased risk of metastasis.

Publication Title

Journal of Clinical Oncology

Volume

44

Issue

7 Supplement

First Page

561

Last Page

561

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