Takashige Abe1, Hiroshi Kitamura2, Wataru Obara3, Nagahide Matsumura4, Taiji Tsukamoto2, Tomoaki Fujioka3, Isao Hara4, Sachiyo Murai5, Nobuo Shinohara5, Katsuya Nonomura5. 1. Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan. Electronic address: takataka@rf6.so-net.ne.jp. 2. Department of Urology, Sapporo Medical University, Sapporo, Japan. 3. Department of Urology, Iwate Medical University, Iwate, Japan. 4. Department of Urology, Wakayama Medical University, Wakayama, Japan. 5. Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Abstract
PURPOSE: We determined prognostic factors associated with prolonged survival after metastasectomy for urothelial carcinoma. MATERIALS AND METHODS: A total of 42 patients who underwent resection of urothelial carcinoma metastases with curative intent at 4 Japanese university hospitals were included in analysis. Of the patients 41 of 42 underwent systemic chemotherapy before and/or after metastasectomy. Overall survival was analyzed using the Kaplan-Meier method. The relationship between clinical characteristics and survival was analyzed using the log rank test. RESULTS: Metastasectomy included lymph node dissection in 20 cases, pulmonary resection in 12, pelvic exenteration in 3, resection of local recurrence in 2, resection of subcutaneous metastasis in 2, liver resection in 1 and other in 2. Median overall survival was 29 months (IQR 19-80) from the initiation of treatment for metastases and 26 months (IQR 11-90) from metastasectomy. The overall 5-year survival rate after metastasectomy was 31%. On univariate analysis patients treated with metastasectomy for a solitary lung or solitary lymph node metastasis had significantly longer survival than the others who underwent metastasectomy (81 vs 19 months, log rank test p = 0.0296). CONCLUSIONS: Long-term cancer control could be achieved in a subgroup of patients who undergo metastasectomy, especially those with a solitary lung or solitary lymph node metastasis.
PURPOSE: We determined prognostic factors associated with prolonged survival after metastasectomy for urothelial carcinoma. MATERIALS AND METHODS: A total of 42 patients who underwent resection of urothelial carcinoma metastases with curative intent at 4 Japanese university hospitals were included in analysis. Of the patients 41 of 42 underwent systemic chemotherapy before and/or after metastasectomy. Overall survival was analyzed using the Kaplan-Meier method. The relationship between clinical characteristics and survival was analyzed using the log rank test. RESULTS: Metastasectomy included lymph node dissection in 20 cases, pulmonary resection in 12, pelvic exenteration in 3, resection of local recurrence in 2, resection of subcutaneous metastasis in 2, liver resection in 1 and other in 2. Median overall survival was 29 months (IQR 19-80) from the initiation of treatment for metastases and 26 months (IQR 11-90) from metastasectomy. The overall 5-year survival rate after metastasectomy was 31%. On univariate analysis patients treated with metastasectomy for a solitary lung or solitary lymph node metastasis had significantly longer survival than the others who underwent metastasectomy (81 vs 19 months, log rank test p = 0.0296). CONCLUSIONS: Long-term cancer control could be achieved in a subgroup of patients who undergo metastasectomy, especially those with a solitary lung or solitary lymph node metastasis.
Authors: Andrea Necchi; Luigi Mariani; Salvatore Lo Vullo; Evan Y Yu; Michael E Woods; Yu-Ning Wong; Lauren C Harshman; Ajjaj Alva; Cora N Sternberg; Aristotelis Bamias; Petros Grivas; Vadim S Koshkin; Florian Roghmann; Jakub Dobruch; Bernie J Eigl; Lucia Nappi; Matthew I Milowsky; Guenter Niegisch; Sumanta K Pal; Ugo De Giorgi; Federica Recine; Ulka Vaishampayan; Dominik D Berthold; Daniel W Bowles; Jack Baniel; Christine Theodore; Sylvain Ladoire; Sandy Srinivas; Neeraj Agarwal; Simon Crabb; Srikala Sridhar; Ali-Reza Golshayan; Carsten Ohlmann; Evanguelos Xylinas; Thomas Powles; Johnathan E Rosenberg; Joaquim Bellmunt; Bas van Rhijn; Matthew D Galsky; Kees Hendricksen Journal: Eur Urol Focus Date: 2017-06-03
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