Outcomes of stage II‑IV upper‑tract urothelial carcinoma and adjuvant chemotherapy for locally advanced cancer

  • Authors:
    • Yi‑Huei Chang
    • Po‑Jen Hsiao
    • Guang‑Heng Chen
    • Ching‑Chan Lin
    • Chao‑Hsiang Chang
    • Hsi‑Chin Wu
    • Chi‑Ping Huang
    • Chi‑Rei Yang
    • Su‑Peng Yeh
  • View Affiliations

  • Published online on: November 7, 2018     https://doi.org/10.3892/ol.2018.9672
  • Pages: 1341-1348
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )


Abstract

The present retrospective study aimed to examine the outcomes of stage II‑IV upper‑tract urothelial carcinoma (UTUC) and determine whether adjuvant chemotherapy is a beneficial treatment for patients with locally advanced UTUC (specifically, stage III‑IV). The analysis included 126 patients with muscle‑invasive UTUC who were treated between June 2003 and June 2012. All patients underwent laparoscopic or open nephroureterectomy and bladder cuff excision. Overall survival (OS), disease‑free survival (DFS), distant metastasis‑free survival (DMFS) and locoregional recurrence‑free survival (LRFS) were assessed. Outcomes were compared between groups of patients with stage II (high‑stage localized) disease, stage III‑IV (high‑stage locally advanced) disease treated with chemotherapy, and stage III‑IV disease not treated with chemotherapy. Among patients with high‑stage locally advanced UTUC (stage III‑IV), those who received adjuvant chemotherapy had significantly better rates of OS (67.1 vs. 33.7%; P=0.004), DFS (70.2 vs. 46.0%; P=0.030) and DMFS (86.3 vs. 65.2%; P=0.048) at 5‑years compared with those who did not undergo adjuvant chemotherapy. However, there was no significant difference between the 5‑year LRFS rates in these two groups (78.2 vs. 62.5%; P=0.525). Importantly, the survival curve of patients with high‑stage UTUC who received adjuvant chemotherapy was similar to that of patients with low‑stage UTUC who underwent surgery only. Multivariate analysis revealed that adjuvant chemotherapy was an independent risk factor for OS [without adjuvant chemotherapy vs. with adjuvant chemotherapy: Hazard ratio (HR), 0.29; 95% confidence interval (CI), 0.129‑0.654; P=0.003] and DFS (without adjuvant chemotherapy vs. with adjuvant chemotherapy: HR, 0.381; 95% CI, 0.168‑0.865; P=0.021). In conclusion, adjuvant chemotherapy may improve the outcome for patients with high‑stage locally advanced UTUC.
View Figures
View References

Related Articles

Journal Cover

January-2019
Volume 17 Issue 1

Print ISSN: 1792-1074
Online ISSN:1792-1082

Sign up for eToc alerts

Recommend to Library

Copy and paste a formatted citation
x
Spandidos Publications style
Chang YH, Hsiao PJ, Chen GH, Lin CC, Chang CH, Wu HC, Huang CP, Yang CR and Yeh SP: Outcomes of stage II‑IV upper‑tract urothelial carcinoma and adjuvant chemotherapy for locally advanced cancer. Oncol Lett 17: 1341-1348, 2019
APA
Chang, Y., Hsiao, P., Chen, G., Lin, C., Chang, C., Wu, H. ... Yeh, S. (2019). Outcomes of stage II‑IV upper‑tract urothelial carcinoma and adjuvant chemotherapy for locally advanced cancer. Oncology Letters, 17, 1341-1348. https://doi.org/10.3892/ol.2018.9672
MLA
Chang, Y., Hsiao, P., Chen, G., Lin, C., Chang, C., Wu, H., Huang, C., Yang, C., Yeh, S."Outcomes of stage II‑IV upper‑tract urothelial carcinoma and adjuvant chemotherapy for locally advanced cancer". Oncology Letters 17.1 (2019): 1341-1348.
Chicago
Chang, Y., Hsiao, P., Chen, G., Lin, C., Chang, C., Wu, H., Huang, C., Yang, C., Yeh, S."Outcomes of stage II‑IV upper‑tract urothelial carcinoma and adjuvant chemotherapy for locally advanced cancer". Oncology Letters 17, no. 1 (2019): 1341-1348. https://doi.org/10.3892/ol.2018.9672