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World Journal of Urology

, Volume 30, Issue 5, pp 701–706 | Cite as

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

  • Atsunari Kawashima
  • Yasutomo Nakai
  • Masashi Nakayama
  • Takeshi Ujike
  • Go Tanigawa
  • Yutaka Ono
  • Akihito Kamoto
  • Tsuyosi Takada
  • Yuichiro Yamaguchi
  • Hitoshi Takayama
  • Kazuo Nishimura
  • Norio Nonomura
  • Akira TsujimuraEmail author
Original Article

Abstract

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.

Keywords

Upper urinary tract Urothelial carcinoma Adjuvant chemotherapy Retrospective study Prognostic factor 

Abbreviations

UUT

Upper urinary tract

CT

Computed tomography

MRI

Magnetic resonance imaging

RNU

Radical nephroureterectomy

UUTC

Carcinoma of upper urinary tract

CSS

Cancer-specific survival

RFS

Recurrence-free survival

AJCC

The American Joint Committee on Cancer

UICC

Union Internationale Contre le Cancer

LVI

Lymphovascular invasion

INF

Infiltrating growth

eGFR

Estimated glomerular filtration rate

M-VAC

Methotrexate, vinblastine, doxorubicin, and cisplatin

GC

Gemcitabine and cisplatin

MEC

Methotrexate, epirubicin, and cisplatin

MEN

Methotrexate, epirubicin, and nedaplatin

HR

Hazard ratio

CI

Confidence interval

Notes

Acknowledgments

The authors wish to thank the investigators, their staff, and the affiliated institutions for the important contribution to this study in The Osaka Urinary Tract Urothelial Carcinoma Collaboration Group: Kensaku Nishimura, Susumu Miyoshi, (Osaka Rosai Hospital); Ken Takeda, (Osaka Medical Center for Cancer and Cardiovascular Diseases); Seiji Yamaguchi, (Osaka General Medical Center Hospital); Yoichi Shiotsuka, Shigeru Nakamori, (Higashiosaka City General Hospital); Toshiaki Yoshioka, (Sumitomo Hospital); Satoko Fukuda, Tsuneo Hara, (Ikeda Municipal Hospital); Hideki Sugao, (Minoh City Hospital); Mototaka Sato, Koji Hatano, Masatoshi Mukai, Akira Nagahara, Motohide Uemura, Daizo Oka, (Osaka University).

Conflict of interest

There are no sources of support to declare, and no author has any financial disclosures or conflicts of interest to declare.

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Atsunari Kawashima
    • 1
  • Yasutomo Nakai
    • 1
  • Masashi Nakayama
    • 2
  • Takeshi Ujike
    • 3
  • Go Tanigawa
    • 4
  • Yutaka Ono
    • 5
  • Akihito Kamoto
    • 6
  • Tsuyosi Takada
    • 7
  • Yuichiro Yamaguchi
    • 8
  • Hitoshi Takayama
    • 1
  • Kazuo Nishimura
    • 2
  • Norio Nonomura
    • 1
  • Akira Tsujimura
    • 1
    Email author
  1. 1.Department of UrologyOsaka University Graduate School of MedicineSuita City, OsakaJapan
  2. 2.Department of UrologyOsaka Medical Center for Cancer and Cardiovascular DiseasesOsakaJapan
  3. 3.Department of UrologyOsaka Rosai HospitalOsakaJapan
  4. 4.Department of UrologyOsaka General Medical Center HospitalOsakaJapan
  5. 5.Department of UrologyHigashiosaka City General HospitalOsakaJapan
  6. 6.Department of UrologySumitomo HospitalOsakaJapan
  7. 7.Department of UrologyIkeda Municipal HospitalOsakaJapan
  8. 8.Department of UrologyMinoh City HospitalOsakaJapan

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