Kazuhiro Kobayashi1, Toshihiro Saito1, Yasuo Kitamura1, Vladimir Bilim1,2, Tomotaka Toba1,2, Takashi Kawasaki3, Noboru Hara1,2,4, Toshiki Tanikawa1, Yoshihiko Tomita2. 1. Department of Urology, Niigata Cancer Center Hospital, Niigata, Japan. 2. Division of Urology, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan. 3. Department of Pathology, Niigata Cancer Center Hospital, Niigata, Japan. 4. Division of Molecular Oncology, Department of Signal Transduction Research, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
Abstract
OBJECTIVES: To determine the effect of preoperative chemotherapy on survival in patients with upper urinary tract urothelial carcinoma clinically involving regional lymph nodes. METHODS: We retrospectively analyzed 55 consecutive patients who received radical nephroureterectomy with or without preoperative chemotherapy for upper urinary tract urothelial carcinoma clinically involving regional lymph nodes at a single institution between January 1991 and December 2013. RESULTS: Median follow up was 18 months (range 2-193). Of 55 patients, 24 (43.6%) received preoperative chemotherapy (study group) and 31 (56.4%) underwent primary surgery (control group). Preoperative chemotherapy consisted of two to four cycles (median 3) of cisplatin-containing regimens. The fraction of patients with lower pathological T stage and N stage than clinical T stage and N stage was higher in the study group (29.2% and 54.2%) compared with the control group (3.2% and 16.1%; P = 0.013 and 0.010, respectively). The 5-year overall survival rate was significantly higher in the study group than in the control group (44.0% vs 12.9%, log-rank, P = 0.003). In multivariate analysis incorporating age at diagnosis, Eastern Cooperative Oncology Group Performance Status, clinical N stage and the number of removed lymph nodes, preoperative chemotherapy was a predictor of better overall survival (P = 0.047, HR 0.47, 95% CI 0.22-0.99). CONCLUSIONS: Preoperative chemotherapy might provide better survival outcomes in patients with upper urinary tract urothelial carcinoma clinically involving regional lymph nodes.
OBJECTIVES: To determine the effect of preoperative chemotherapy on survival in patients with upper urinary tract urothelial carcinoma clinically involving regional lymph nodes. METHODS: We retrospectively analyzed 55 consecutive patients who received radical nephroureterectomy with or without preoperative chemotherapy for upper urinary tract urothelial carcinoma clinically involving regional lymph nodes at a single institution between January 1991 and December 2013. RESULTS: Median follow up was 18 months (range 2-193). Of 55 patients, 24 (43.6%) received preoperative chemotherapy (study group) and 31 (56.4%) underwent primary surgery (control group). Preoperative chemotherapy consisted of two to four cycles (median 3) of cisplatin-containing regimens. The fraction of patients with lower pathological T stage and N stage than clinical T stage and N stage was higher in the study group (29.2% and 54.2%) compared with the control group (3.2% and 16.1%; P = 0.013 and 0.010, respectively). The 5-year overall survival rate was significantly higher in the study group than in the control group (44.0% vs 12.9%, log-rank, P = 0.003). In multivariate analysis incorporating age at diagnosis, Eastern Cooperative Oncology Group Performance Status, clinical N stage and the number of removed lymph nodes, preoperative chemotherapy was a predictor of better overall survival (P = 0.047, HR 0.47, 95% CI 0.22-0.99). CONCLUSIONS: Preoperative chemotherapy might provide better survival outcomes in patients with upper urinary tract urothelial carcinoma clinically involving regional lymph nodes.
Authors: Mario Alvarez-Maestro; Juan Gómez Rivas; Sergio Alonso Y Gregorio; Cristina de Castro Guerin; Ángel Tabernero Gómez; Jesús Cisneros Ledo Journal: Cent European J Urol Date: 2016-11-30
Authors: Georgios Gakis; Tina Schubert; Mehrdad Alemozaffar; Joaquim Bellmunt; Bernard H Bochner; Steven A Boorjian; Siamak Daneshmand; William C Huang; Tsunenori Kondo; Badrinath R Konety; Maria Pilar Laguna; Surena F Matin; Arlene O Siefker-Radtke; Shahrokh F Shariat; Arnulf Stenzl Journal: World J Urol Date: 2016-04-04 Impact factor: 4.226