比較侵犯型上泌尿道上皮腫瘤接受MEC及GC兩種輔助化學治療之預後
洪晟鈞、王賢祥、楊晨洸、李建儀、程千里、歐宴泉、賀昊中、裘坤元及陳卷書
臺中榮民總醫院醫院 外科部 泌尿科
Comparison of the efficacy of adjuvant MEC (methotrexate, epirubicin and cisplatin) and GC (gemcitabine and cisplatin) in advanced upper tract urothelial carcinoma
Sheng-chun Hung, Shian-Shiang Wang, Chun-Kuang Yang, Jian-Ri Li, Chen-Li Cheng, Yen-Chuan Ou, Hao-Chung Ho, Kun-Yuan Chiu and Chuan-Shu Chen
Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
Purpose: To evaluate the efficacy of Methotrexate, Epirubicin and Cisplatin (MEC) or Gemcitabine and Cisplatin (GC) as adjuvant chemotherapy in advanced upper tract urothelium carcinoma (UTUC).
Patients and Methods: From 2002 January to 2008 December, a total of 70 patients with advanced UTUC received a radical nephroureterctomy at our institute with MEC and GC as adjuvant chemotherapy. Disease-free survival (DFS), cancer-specific survival (CSS) and overall survival (OS) among the two groups were evaluated.
Results: The MEC group (n=30) and GC group (n=40) were compared and showed no significant differences in DFS (p=0.859), CSS (p=0.722) and OS (p=0.691). Positive lymph nodes, preoperative creatinine >1.5, old age, a high ECOG state and low BMI are all the independent risk factors of poor prognosis in advanced UTUC. Conclusions: In patients with UTUC, MEC has a non-inferior efficacy to GC in consideration of cancer recurrence, cancer specific survival and overall survival.