Adjuvant chemotherapy (AC) improves recurrence-free survival in patients with locally advanced upper tract urothelial carcinoma (UTUC), according to a new study. The treatment has no significant effect on cancer-specific or overall survival, however.
A team led by Hyun Hwan Sung, MD, of Samsung Medical Center, Sungkyunkwan University School of Medicine in Seoul, Korea, studied 293 patients who underwent radical nephroureterectomy for pT3NanyM0 UTUC from 1995 to 2017. Of these, 127 (43.3%) received cisplatin-based AC. During a mean follow-up period of 59.7 months, the investigators identified recurrence and/or distant metastasis in 124 patients (42.3%) and 106 patients (36.2%) died. Of the patients who died, 93 (31.7%) died from UTUC.
The 5-year recurrence-free, cancer-specific, and overall survival rates overall were 51.3%, 68%, and 64.7%, respectively, Dr Sung and colleagues reported in the International Journal of Surgery. The 5-year recurrence-free survival rate was 58% among AC recipients compared with 44% of patients who did not receive AC.
On multivariable analysis, AC was associated with a significant 26% decreased risk of tumor recurrence compared with no AC, but was not associated with cancer-specific or all-cause mortality.
The authors stated that, to the best of their knowledge, their study was the largest to date performed at a single institute to analyze the impact of AC on survival in this patient group.
Song W, Jeong JY, Jeon HG, et al. Impact of adjuvant chemotherapy on oncologic outcmoes following radical nephroureterectomy for patients with pT3anyM0 upper tract urothelial carcinoma: A retrospective cohort study. Int J Surg. 2019.