Urology Medical News about Adjuvant chemotherapy, urothelial carcinoma

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Adjuvant chemotherapy for high-risk upper tract urothelial carcinoma: results from the Upper Tract Urothelial Carcinoma Collaboration
The Journal of Urology, 08/19/09

Hellenthal NJ et al. – In a study to determine the incidence of adjuvant chemotherapy in high-risk pts and the ensuing effect on overall and cancer specific survival, it was reported that adjuvant chemotherapy is infrequently used to treat high-risk upper tract urothelial carcinoma after nephroureterectomy. Despite this finding, it appears that adjuvant chemotherapy confers minimal impact on overall or cancer-specific survival in this group.

Methods

1390 pts were identified who underwent nephroureterectomy for nonmetastatic upper tract urothelial carcinoma.
542 (39%) of 1390 cases were classified as high risk (pT3N0, pT4N0 and/or lymph node-positive).
Pts were divided into 2 groups, including those who did and did not receive adjuvant chemotherapy, and stratified by gender, age group, performance status, and tumor grade and stage.
Cox proportional hazard modeling and Kaplan-Meier analysis were used to determine overall and cancer specific survival.

Results

Of high-risk pts, 121 (22%) received adjuvant chemotherapy.
Adjuvant chemotherapy was more commonly administered in the context of increased tumor grade and stage.
Median survival in the cohort was 24 mos (range 0 to 231).
There was no significant difference in overall or cancer specific survival between pts who did and did not receive adjuvant chemotherapy.
Age, performance status, and tumor grade and stage were significant predictors of overall and cancer specific survival.

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