The result of adjuvant chemotherapy for localized pT3 upper urinary tract carcinoma in a multi-institutional study

• Published in: World journal of urology 2012-10, Vol.30 (5), p.701-706
• Main Authors: Kawashima, Atsunari, Nakai, Yasutomo, Nakayama, Masashi, Ujike, Takeshi, Tanigawa, Go, Ono, Yutaka, Kamoto, Akihito, Takada, Tsuyosi, Yamaguchi, Yuichiro, Takayama, Hitoshi, Nishimura, Kazuo, Nonomura, Norio, Tsujimura, Akira
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Chemotherapy, Adjuvant - methods; Cisplatin - therapeutic use; Combined Modality Therapy; Cytarabine - therapeutic use; Databases, Factual - statistics & numerical data; Doxorubicin - therapeutic use; Etoposide - therapeutic use; Female; Humans; Kaplan-Meier Estimate; Male; Medical sciences; Medicine; Medicine & Public Health; Methotrexate - therapeutic use; Middle Aged; Mitoxantrone - therapeutic use; Multivariate Analysis; Nephrectomy - mortality; Nephrology; Nephrology. Urinary tract diseases; Oncology; Original Article; Prognosis; Proportional Hazards Models; Retrospective Studies; Ureteral Neoplasms - drug therapy; Ureteral Neoplasms - mortality; Ureteral Neoplasms - surgery; Urology; Vinblastine - therapeutic use
• ISSN: 0724-4983; 1433-8726
• DOI: 10.1007/s00345-011-0775-z

Purpose To determine through the analysis of our multi-institutional database whether postoperative adjuvant chemotherapy for upper urinary tract carcinoma with localized invasive upper urinary tract carcinoma (UUTC) is beneficial. Methods A study population of 93 patients with pT3N0/xM0 UUTC was eligible for this study. Clinical features evaluated were sex, tumor location, adjuvant chemotherapy status, tumor pathology (histology, grade, infiltrating growth, lymphovascular invasion (LVI)), and cause of death. Cancer-specific survival (CSS) was estimated by Kaplan–Meier method. Prognostic factors related to CSS were analyzed by Cox proportional hazards regression model for multivariate analysis. Results In pT3 patients, overall 5-year CSS rate was 68.4% and median CSS time was 31 months (range 3–114 months). In the adjuvant chemotherapy group, 5-year CSS rate was 80.8%, whereas 5-year CSS rate was 64.4% in the non-adjuvant chemotherapy group. By multivariate analysis, adjuvant chemotherapy status was significantly associated with CSS ( P  = 0.008) were sex, tumor grade, tumor histology, and LVI presence. Conclusions This study, although it was retrospective study, revealed that adjuvant chemotherapy after RNU may be beneficial in pT3N0/X patients by multivariate analysis. Prospective studies evaluating adjuvant therapy regimens for UTTC are required.