Oncological outcomes of neoadjuvant chemotherapy in patients with locally advanced upper tract urothelial carcinoma: a multicenter study

• Kubota, Yuka

• Hatakeyama, Shingo

• Tanaka, Toshikazu

• Fujita, Naoki

• Iwamura, Hiromichi

• Mikami, Jotaro

• Yamamoto, Hayato

• Tobisawa, Yuki

• Yoneyama, Tohru

• Yoneyama, Takahiro

• Hashimoto, Yasuhiro

• Koie, Takuya

• Ito, Hiroyuki

• Yoshikawa, Kazuaki

• Sasaki, Atsushi

• Kawaguchi, Toshiaki

• Ohyama, Chikara

抄録

Objective: The clinical impact of neoadjuvant chemotherapy (NAC) on oncological outcomes in patients with locally advanced upper tract urothelial carcinoma (UTUC) remains unclear. We investigated the oncological outcomes of platinum-based NAC for locally advanced UTUC. Results: Of 234 patients, 101 received NAC (NAC group) and 133 did not (Control [Ctrl] group). The regimens in the NAC group included gemcitabine and carboplatin (75%), and gemcitabine and cisplatin (21%). Pathological downstagings of the primary tumor and lymphovascular invasion were significantly improved in the NAC than in the Ctrl groups. NAC for locally advanced UTUC significantly prolonged recurrence-free and cancer-specific survival. Multivariate Cox regression analysis using an inverse probability of treatment weighted (IPTW) method showed that NAC was selected as an independent predictor for prolonged recurrence-free and cancer-specific survival. However, the influence of NAC on overall survival was not statistically significant. Materials and Methods: A total of 426 patients who underwent radical nephroureterectomy at five medical centers between January 1995 and April 2017 were examined retrospectively. Of the 426 patients, 234 were treated for a highrisk disease (stages cT3-4 or locally advanced [cN+] disease) with or without NAC. NAC regimens were selected based on eligibility of cisplatin. We retrospectively evaluated post-therapy pathological downstaging, lymphovascular invasion, and prognosis stratified by NAC use. Multivariate Cox regression analysis was performed for independent factors for prognosis. Conclusions: Platinum-based NAC for locally advanced UTUC potentially improves oncological outcomes. Further prospective studies are needed to clarify the clinical benefit of NAC for locally advanced UTUC.

収録刊行物

• ONCOTARGET

  ONCOTARGET 8 (60), 101500-101508, 2017-11-24

  Impact Journals, LLC

キーワード

• Oncology

詳細情報

• CRID: 1050845762947690240
• NII論文ID: 120006583353
• ISSN: 19492553
• DOI: 10.18632/oncotarget.21551
• HANDLE: 10129/00006551
• Web Site: https://hirosaki.repo.nii.ac.jp/records/5480
• Web Site: https://www.oncotarget.com/lookup/doi/10.18632/oncotarget.21551
• 本文言語コード: en
• 資料種別: journal article
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