Clinical Efficacy of Adjuvant Chemotherapy in Advanced Upper Tract Urothelial Carcinoma (pT3-T4): Real-World Data from the Taiwan Upper Tract Urothelial Carcinoma Collaboration Group
Journal
Journal of personalized medicine
Journal Volume
12
Journal Issue
2
Date Issued
2022-02-06
Author(s)
Lin, Chung-Yu
Weng, Han-Yu
Tai, Ta-Yao
Wu, Hsi-Chin
Chen, Wen-Chi
Lo, Chi-Wen
Yu, Chih-Chin
Tsai, Chung-You
Wu, Wei-Che
Jiang, Yuan-Hong
Lee, Yu-Khun
Hsueh, Thomas Y
Chiu, Allen W
Chiang, Bing-Juin
Huang, Hsu-Che
Chen, I-Hsuan Alan
Chen, Yung-Tai
Lin, Wei-Yu
Wu, Chia-Chang
Tsai, Yao-Chou
Lee, Hsiang-Ying
Li, Wei-Ming
Abstract
The clinical efficacy of adjuvant chemotherapy in upper tract urothelial carcinoma (UTUC) is unclear. We aimed to assess the therapeutic outcomes of adjuvant chemotherapy in patients with advanced UTUC (pT3-T4) after radical nephroureterectomy (RNU). We retrospectively reviewed the data of 2108 patients from the Taiwan UTUC Collaboration Group between 1988 and 2018. Comprehensive clinical features, pathological characteristics, and survival outcomes were recorded. Univariate and multivariate Cox proportional hazards models were used to evaluate overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS). Of the 533 patients with advanced UTUC included, 161 (30.2%) received adjuvant chemotherapy. In the multivariate analysis, adjuvant chemotherapy was significantly associated with a reduced risk of overall death (hazard ratio (HR), 0.599; 95% confidence interval (CI), 0.419-0.857; p = 0.005), cancer-specific mortality (HR, 0.598; 95% CI, 0.391-0.914; p = 0.018), and cancer recurrence (HR, 0.456; 95% CI, 0.310-0.673; p < 0.001). The Kaplan-Meier survival analysis revealed that patients receiving adjuvant chemotherapy had significantly better five-year OS (64% vs. 50%, p = 0.002), CSS (70% vs. 62%, p = 0.043), and DFS (60% vs. 48%, p = 0.002) rates compared to those who did not receive adjuvant chemotherapy. In conclusion, adjuvant chemotherapy after RNU had significant therapeutic benefits on OS, CSS, and DFS in advanced UTUC.
Subjects
chemotherapy; prognosis; upper tract urothelial carcinoma
Publisher
MDPI
Type
journal article