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- Title
Outcomes of stage II–IV upper-tract urothelial carcinoma and adjuvant chemotherapy for locally advanced cancer.
- Authors
Chang, Yi-Huei; Hsiao, Po-Jen; Chen, Guang-Heng; Lin, Ching-Chan; Chang, Chao-Hsiang; Wu, Hsi-Chin; Huang, Chi-Ping; Yang, Chi-Rei; Yeh, Su-Peng
- Abstract
The present retrospective study aimed to examine the outcomes of stage II–IV upper-tract urothelial carcinoma (UTUC) and determine whether adjuvant chemotherapy is a beneficial treatment for patients with locally advanced UTUC (specifically, stage III–IV). The analysis included 126 patients with muscle-invasive UTUC who were treated between June 2003 and June 2012. All patients underwent laparoscopic or open nephroureterectomy and bladder cuff excision. Overall survival (OS), disease-free survival (DFS), distant metastasis-free survival (DMFS) and locoregional recurrence-free survival (LRFS) were assessed. Outcomes were compared between groups of patients with stage II (high-stage localized) disease, stage III–IV (high-stage locally advanced) disease treated with chemotherapy, and stage III–IV disease not treated with chemotherapy. Among patients with high-stage locally advanced UTUC (stage III–IV), those who received adjuvant chemotherapy had significantly better rates of OS (67.1 vs. 33.7%; P=0.004), DFS (70.2 vs. 46.0%; P=0.030) and DMFS (86.3 vs. 65.2%; P=0.048) at 5-years compared with those who did not undergo adjuvant chemotherapy. However, there was no significant difference between the 5-year LRFS rates in these two groups (78.2 vs. 62.5%; P=0.525). Importantly, the survival curve of patients with high-stage UTUC who received adjuvant chemotherapy was similar to that of patients with low-stage UTUC who underwent surgery only. Multivariate analysis revealed that adjuvant chemotherapy was an independent risk factor for OS [without adjuvant chemotherapy vs. with adjuvant chemotherapy: Hazard ratio (HR), 0.29; 95% confidence interval (CI), 0.129–0.654; P=0.003] and DFS (without adjuvant chemotherapy vs. with adjuvant chemotherapy: HR, 0.381; 95% CI, 0.168–0.865; P=0.021). In conclusion, adjuvant chemotherapy may improve the outcome for patients with high-stage locally advanced UTUC.
- Subjects
MULTIVARIATE analysis; CONFIDENCE intervals; PROGRESSION-free survival; CARCINOMA
- Publication
Oncology Letters, 2019, Vol 17, Issue 1, p1341
- ISSN
1792-1074
- Publication type
Article