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

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World Journal of Urology Aims and scope Submit manuscript

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.

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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

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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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Authors and Affiliations

  1. Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka, 565-0871, Japan

    Atsunari Kawashima, Yasutomo Nakai, Hitoshi Takayama, Norio Nonomura & Akira Tsujimura

  2. Department of Urology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan

    Masashi Nakayama & Kazuo Nishimura

  3. Department of Urology, Osaka Rosai Hospital, Osaka, Japan

    Takeshi Ujike

  4. Department of Urology, Osaka General Medical Center Hospital, Osaka, Japan

    Go Tanigawa

  5. Department of Urology, Higashiosaka City General Hospital, Osaka, Japan

    Yutaka Ono

  6. Department of Urology, Sumitomo Hospital, Osaka, Japan

    Akihito Kamoto

  7. Department of Urology, Ikeda Municipal Hospital, Osaka, Japan

    Tsuyosi Takada

  8. Department of Urology, Minoh City Hospital, Osaka, Japan

    Yuichiro Yamaguchi

Authors
  1. Atsunari Kawashima
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  2. Yasutomo Nakai
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  3. Masashi Nakayama
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  4. Takeshi Ujike
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  5. Go Tanigawa
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  6. Yutaka Ono
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  7. Akihito Kamoto
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  8. Tsuyosi Takada
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  9. Yuichiro Yamaguchi
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  10. Hitoshi Takayama
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  11. Kazuo Nishimura
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  12. Norio Nonomura
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  13. Akira Tsujimura
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Corresponding author

Correspondence to Akira Tsujimura.

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Kawashima, A., Nakai, Y., Nakayama, M. et al. The result of adjuvant chemotherapy for localized pT3 upper urinary tract carcinoma in a multi-institutional study. World J Urol 30, 701–706 (2012). https://doi.org/10.1007/s00345-011-0775-z

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  • DOI: https://doi.org/10.1007/s00345-011-0775-z

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