Clinical Efficacy of Adjuvant Chemotherapy in Advanced Upper Tract Urothelial Carcinoma (pT3-T4): Real-World Data from the Taiwan Upper Tract Urothelial Carcinoma Collaboration Group

Chung Yu Lin, Han Yu Weng, Ta Yao Tai, Hsi Chin Wu, Wen Chi Chen, Chung Hsin Chen, Chao Yuan Huang, Chi Wen Lo, Chih Chin Yu, Chung You Tsai, Wei Che Wu, Yuan Hong Jiang, Yu Khun Lee, Thomas Y. Hsueh, Allen W. Chiu, Bing Juin Chiang, Hsu Che Huang, I. Hsuan Alan Chen, Yung Tai Chen, Wei Yu LinChia Chang Wu, Yao Chou Tsai, Hsiang Ying Lee, Wei Ming Li

Research output: Contribution to journalArticlepeer-review

Abstract

The clinical efficacy of adjuvant chemotherapy in upper tract urothelial carcinoma (UTUC) is unclear. We aimed to assess the therapeutic outcomes of adjuvant chemotherapy in patients with advanced UTUC (pT3-T4) after radical nephroureterectomy (RNU). We retrospectively reviewed the data of 2108 patients from the Taiwan UTUC Collaboration Group between 1988 and 2018. Comprehensive clinical features, pathological characteristics, and survival outcomes were recorded. Univariate and multivariate Cox proportional hazards models were used to evaluate overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS). Of the 533 patients with advanced UTUC included, 161 (30.2%) received adjuvant chemotherapy. In the multivariate analysis, adjuvant chemotherapy was significantly associated with a reduced risk of overall death (hazard ratio (HR), 0.599; 95% confidence interval (CI), 0.419–0.857; p = 0.005), cancer-specific mortality (HR, 0.598; 95% CI, 0.391–0.914; p = 0.018), and cancer recurrence (HR, 0.456; 95% CI, 0.310–0.673; p < 0.001). The Kaplan–Meier survival analysis revealed that patients receiving adjuvant chemotherapy had significantly better five-year OS (64% vs. 50%, p = 0.002), CSS (70% vs. 62%, p = 0.043), and DFS (60% vs. 48%, p = 0.002) rates compared to those who did not receive adjuvant chemotherapy. In conclusion, adjuvant chemotherapy after RNU had significant therapeutic benefits on OS, CSS, and DFS in advanced UTUC.

Original languageEnglish
Article number226
JournalJournal of Personalized Medicine
Volume12
Issue number2
DOIs
Publication statusPublished - Feb 2022

Keywords

  • Chemotherapy
  • Prognosis
  • Upper tract urothelial carcinoma

ASJC Scopus subject areas

  • Medicine (miscellaneous)

Fingerprint

Dive into the research topics of 'Clinical Efficacy of Adjuvant Chemotherapy in Advanced Upper Tract Urothelial Carcinoma (pT3-T4): Real-World Data from the Taiwan Upper Tract Urothelial Carcinoma Collaboration Group'. Together they form a unique fingerprint.

Cite this