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Comparison of Pathological Stage in Patients Treated with and without Neoadjuvant Chemotherapy for High Risk Upper Tract Urothelial Carcinoma

Liao, Ross S. ; Gupta, Mohit ; Schwen, Zeyad R. ; Patel, Hiten D. ; Kates, Max ; Johnson, Michael H. ; Hahn, Noah M. ; McConkey, David ; Bivalacqua, Trinity J. ; Pierorazio, Phillip M.

The Journal of urology, 2018-07, Vol.200 (1), p.68-73 [Periódico revisado por pares]

United States: Elsevier Inc

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Título:
Comparison of Pathological Stage in Patients Treated with and without Neoadjuvant Chemotherapy for High Risk Upper Tract Urothelial Carcinoma
Autor: Liao, Ross S. ; Gupta, Mohit ; Schwen, Zeyad R. ; Patel, Hiten D. ; Kates, Max ; Johnson, Michael H. ; Hahn, Noah M. ; McConkey, David ; Bivalacqua, Trinity J. ; Pierorazio, Phillip M.
Assuntos: Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents - administration & dosage ; Antineoplastic Combined Chemotherapy Protocols - administration & dosage ; carcinoma ; Carcinoma, Transitional Cell - drug therapy ; Carcinoma, Transitional Cell - pathology ; Carcinoma, Transitional Cell - surgery ; chemotherapy ; Chemotherapy, Adjuvant ; Combined Modality Therapy ; Deoxycytidine - administration & dosage ; Deoxycytidine - analogs & derivatives ; Female ; Humans ; kidney neoplasms ; Kidney Neoplasms - drug therapy ; Kidney Neoplasms - pathology ; Kidney Neoplasms - surgery ; Kidney Pelvis - pathology ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Staging ; Nephroureterectomy ; Retrospective Studies ; transitional cell ; Ureter - pathology ; ureteral neoplasms ; Ureteral Neoplasms - drug therapy ; Ureteral Neoplasms - pathology ; Ureteral Neoplasms - surgery
É parte de: The Journal of urology, 2018-07, Vol.200 (1), p.68-73
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SourceType-Scholarly Journals-1
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Descrição: High risk upper tract urothelial carcinoma has been associated with poor survival outcomes. Limited retrospective data support neoadjuvant chemotherapy prior to radical nephroureterectomy. To validate prior findings we evaluated differences in the pathological stage distribution in patients with high risk upper tract urothelial carcinoma based on the administration of neoadjuvant chemotherapy before radical nephroureterectomy. We retrospectively analyzed the records of 240 patients with upper tract urothelial carcinoma at The Johns Hopkins Hospital from 2003 to 2017. Patients with biopsy proven high grade disease and a visible lesion on cross-sectional imaging were offered neoadjuvant chemotherapy prior to radical nephroureterectomy. A control group of a time matched cohort of patients with biopsy proven high grade disease underwent extirpative surgery alone. The chi-square and Fisher exact tests were used to evaluate clinical and pathological variables between the cohorts. There were 32 patients in the study group and 208 in the control group. Significantly lower pathological stage was noted in the study group than in the control group (p <0.001). Significantly fewer patients with pT2 disease or higher were treated with neoadjuvant chemotherapy (37.5% vs 59.6%, p = 0.02). There was a 46.5% reduction in the prevalence of pT3 disease or higher in study group patients without clinically node positive or low volume metastatic disease (25.9% vs 48.4%, p = 0.04). A 9.4% complete remission rate was observed in patients who underwent neoadjuvant chemotherapy. Patients with high risk upper tract urothelial carcinoma treated with neoadjuvant chemotherapy were noted to have a lower pathological stage distribution than patients treated with radical nephroureterectomy alone.
Editor: United States: Elsevier Inc
Idioma: Inglês

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Comparison of Pathological Stage in Patients Treated with and without Neoadjuvant Chemotherapy for High Risk Upper Tract Urothelial Carcinoma

Liao, Ross S. ; Gupta, Mohit ; Schwen, Zeyad R. ; Patel, Hiten D. ; Kates, Max ; Johnson, Michael H. ; Hahn, Noah M. ; McConkey, David ; Bivalacqua, Trinity J. ; Pierorazio, Phillip M.

United States: Elsevier Inc

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