Pd20-10 Comparison of Neoadjuvant and Adjuvant Chemotherapy for Upper Tract Urothelial Carcinoma in Real-World Practice: A Multicenter Retrospective Study

You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma I (PD20)1 May 2024PD20-10 COMPARISON OF NEOADJUVANT AND ADJUVANT CHEMOTHERAPY FOR UPPER TRACT UROTHELIAL CARCINOMA IN REAL-WORLD PRACTICE: A MULTICENTER RETROSPECTIVE STUDY Katsuki Muramoto, Fumihiko Urabe, Hirokazu Kagawa, Kazuhiro Takahashi, Kosuke Iwatani, Yu Imai, Kojiro Tashiro, Takafumi Yanagisawa, Shunsuke Tsuzuki, Jun Miki, and Takahiro Kimura Katsuki MuramotoKatsuki Muramoto , Fumihiko UrabeFumihiko Urabe , Hirokazu KagawaHirokazu Kagawa , Kazuhiro TakahashiKazuhiro Takahashi , Kosuke IwataniKosuke Iwatani , Yu ImaiYu Imai , Kojiro TashiroKojiro Tashiro , Takafumi YanagisawaTakafumi Yanagisawa , Shunsuke TsuzukiShunsuke Tsuzuki , Jun MikiJun Miki , and Takahiro KimuraTakahiro Kimura View All Author Informationhttps://doi.org/10.1097/01.JU.0001009556.54476.eb.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Multiple studies have demonstrated the effectiveness of neoadjuvant chemotherapy (NAC) and adjuvant chemotherapy (AC) in patients with upper tract urothelial carcinoma (UTUC), compared to surgery alone. However, no clinical trial has established the superiority of NAC or AC in terms of perioperative outcomes. METHODS: We conducted a retrospective analysis encompassing 164 UTUC patients who underwent radical nephroureterectomy and received perioperative chemotherapy. Of these patients, 65 (39.6%) and 99 (60.4%) received NAC and AC, respectively. Recurrence-free survival (RFS) and cancer-specific survival (CSS) were computed using the Kaplan-Meier method. Additionally, we conducted Cox regression analyses to evaluate the risk factors for RFS and CSS. As a sub-analysis, we also examined the impact of NAC within each cohort encompassing renal pelvic cancer and ureteral cancer. RESULTS: Pathological downstaging was seen in 37% of the NAC group. However, no pathological complete response was observed in this cohort. During the follow-up period, 86 (52.4%) patients experienced recurrence and 48 (29.3%) experienced cancer-specific mortality. The 3-year RFS and CSS were 47.2% and 67.7%, respectively. The Kaplan-Meier curves demonstrated significantly lower RFS and CSS in patients who received AC (Figure 1a Figure 1c Figure 1e & f). CONCLUSIONS: Our study has suggested that NAC would be more effective in high-risk UTUC patients, compared to AC. Considering the potential risk for renal dysfunction postoperatively, NAC might be an optimal approach, increasing the likelihood of achieving radical surgery in high-risk UTUC patients. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e450 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Katsuki Muramoto More articles by this author Fumihiko Urabe More articles by this author Hirokazu Kagawa More articles by this author Kazuhiro Takahashi More articles by this author Kosuke Iwatani More articles by this author Yu Imai More articles by this author Kojiro Tashiro More articles by this author Takafumi Yanagisawa More articles by this author Shunsuke Tsuzuki More articles by this author Jun Miki More articles by this author Takahiro Kimura More articles by this author Expand All Advertisement PDF downloadLoading ...