劉家翔¹、黃逸修^{1, 3}、林登龍^{1, 3}

台北榮民總醫院泌尿部¹國立陽明大學醫學系泌尿學科²書田泌尿科學研究中心³

Adjuvant chemotherapy for locally advanced upper tract urothelial carcinoma: updated results of the Taipei Veterans General Hospital experience

Chia-Hsiang Liu¹, Eric Yi-Hsiu Huang^1,3, Alex T. L. Lin^1,3

¹ Department of Urology; ²Department of Radiology,
Taipei Veterans General Hospital, Taiwan

³ Department of Urology, School of Medicine, and Shu-Tien Urological Institute,
National Yang-Ming University, Taipei, Taiwan

 

To describe the long-term outcome in the treatment of locally advanced upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU) regarding the role of adjuvant chemotherapy.

 

Clinical data from 93 patients who underwent RNU from 2005 to 2010 for locally advanced UTUC ( pT3N0) were analyzed.

 

We selected 102 patients and 9 were excluded due to loss of follow-up.The adjuvant chemotherapy group comprised 63 patients, and other 30 patients did not receive adjuvant chemotherapy. The median follow-up period was 34 months for non-adjuvant chemotherapy group and 31.5 months for adjuvant chemotherapy group.Bladder recurrence rate was 33.33% for the non-adjuvant chemotherapy group versus 22.22% for the adjuvant chemotherapy group.Distant metastasis rate was 23.33% for the non-adjuvant chemotherapy group versus 33.33% for the adjuvant chemotherapy group The 5-year survival rates was 30% for the non-adjuvant chemotherapy group versus 36.5% for the adjuvant chemotherapy group .Overall survival (OS) rates was 70% for the non-adjuvant chemotherapy group versus 65.07% for the adjuvant chemotherapy group . Progression free survival rate was 40% for the non-adjuvant chemotherapy group versus 42.85% for the adjuvant chemotherapy group.

 

There does not appear to be a significant over bladder recurrence,distant metastasis, 5-year survival,overaall survival or progression free survival associated with adjuvant chemotherapy. Relative less data base than previous study was limitation.Prospective randomized clinical trials are necessary to verify the effect of adjuvant chemotherapy on locally advanced UTUC(pT3N0).