Pd20-05 Real-World Data: Call for Paradigm Shift Towards Neoadjuvant Chemotherapy in Patients With Upper Tract Urothelial Carcinoma Treated With Nephroureterectomy—analysis of the Robuust Registry

You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma I (PD20)1 May 2024PD20-05 REAL-WORLD DATA: CALL FOR PARADIGM SHIFT TOWARDS NEOADJUVANT CHEMOTHERAPY IN PATIENTS WITH UPPER TRACT UROTHELIAL CARCINOMA TREATED WITH NEPHROURETERECTOMY—ANALYSIS OF THE ROBUUST REGISTRY Gabriele Tuderti, Flavia Proietti, Zhenjie Wu, Antonio Franco, Linhui Wang, Vitaly Margulis, Raj Bhanvadia, Firas Abdollah, Marco Finati, Alessandro Antonelli, Francesco Ditonno, Nirmish Singla, Stephan Broenimann, Ithaar H. Derweesh, Dhruv Puri, Soroush Rais-Bahrami, Sol C. Moon, Matteo Ferro, Marco Tozzi, Francesco Porpiglia, Enrico Checcucci, Andreas Correa, Emma Helstrom, Mark L. Gonzalgo, Dinno F. Mendiola, Sisto Perdonà, Antonio Tufano, Benjamine M. Eilender, Reza Mehrazin, Courtney Yong, Chandru P. Sundaram, Alireza Ghoreifi, Hooman Djaladat, Riccardo Autorino, and Giuseppe Simone Gabriele TudertiGabriele Tuderti , Flavia ProiettiFlavia Proietti , Zhenjie WuZhenjie Wu , Antonio FrancoAntonio Franco , Linhui WangLinhui Wang , Vitaly MargulisVitaly Margulis , Raj BhanvadiaRaj Bhanvadia , Firas AbdollahFiras Abdollah , Marco FinatiMarco Finati , Alessandro AntonelliAlessandro Antonelli , Francesco DitonnoFrancesco Ditonno , Nirmish SinglaNirmish Singla , Stephan BroenimannStephan Broenimann , Ithaar H. DerweeshIthaar H. Derweesh , Dhruv PuriDhruv Puri , Soroush Rais-BahramiSoroush Rais-Bahrami , Sol C. MoonSol C. Moon , Matteo FerroMatteo Ferro , Marco TozziMarco Tozzi , Francesco PorpigliaFrancesco Porpiglia , Enrico CheccucciEnrico Checcucci , Andreas CorreaAndreas Correa , Emma HelstromEmma Helstrom , Mark L. GonzalgoMark L. Gonzalgo , Dinno F. MendiolaDinno F. Mendiola , Sisto PerdonàSisto Perdonà , Antonio TufanoAntonio Tufano , Benjamine M. EilenderBenjamine M. Eilender , Reza MehrazinReza Mehrazin , Courtney YongCourtney Yong , Chandru P. SundaramChandru P. Sundaram , Alireza GhoreifiAlireza Ghoreifi , Hooman DjaladatHooman Djaladat , Riccardo AutorinoRiccardo Autorino , and Giuseppe SimoneGiuseppe Simone View All Author Informationhttps://doi.org/10.1097/01.JU.0001009556.54476.eb.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Preliminary results of phase II trials support the effectiveness of neoadjuvant (Nad) chemotherapy (CHT) for high-grade upper tract urothelial carcinoma (UTUC), although available data are still immature. In this study we assessed the role of perioperative CHT in a large multicenter cohort of patients with UTUC, treated with nephroureterectomy (NUT). METHODS: A multicenter retrospective analysis utilizing the ROBUUST (ROBotic surgery for Upper tract urothelial cancer STudy) registry was performed. Baseline, preoperative, perioperative, and pathologic variables of three groups of patients receiving NUT only, Nad-CHT or Adjuvant (Ad) CHT were compared. Categorical and continuous variables among the three subgroups were compared with Chi square and ANOVA tests, respectively. Stage-specific (cT 0-2, cT≥3 and cN+) Kaplan-Meier analysis were performed to compare Cancer-specific survival (CSS) probabilities. RESULTS: Overall, 1994 patients were included. Nad-CHT patients displayed a significantly higher rate of cT stage≥3 (p<0.001) and cN positive stage (p<0.001). Overall complications and Clavien grade≥3 complications rates were comparable among the three subgroups (p=0.65 and p=0.92, respectively). At Kaplan-Meier analysis specific for cT0-2 patients, no significant differences were detected among the three groups of patients (24-mo: Nad-CHT 89.2%, NUT 91.5%, Ad-CHT 88.8%; p=0.34). On the other hand, at Kaplan-Meier curve specific for cT≥3 stage, Nad-CHT showed a significantly higher rate of CSS than the other two cohorts (24-mo: Nad-CHT 81.1%, NUT 66.9%, Ad-CHT 69.9%; p=0.03). Accordingly, at Kaplan-Meier analysis specific for cN positive patients, Nad-CHT showed a significantly higher rate of CSS than the other two cohorts (24-mo: Nad-CHT 75.6%, NUT 63.6%, Ad-CHT 59.4%, p=0.03). CONCLUSIONS: Our retrospective analysis of a large multicenter dataset suggests that, in specific scenarios, such as locally advanced and clinically positive nodes disease, NadCHT seems to offer a significant benefit in terms of CSS, with a negligible impact on surgical morbidity. Further data from randomised controlled trials are expected. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e448 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Gabriele Tuderti More articles by this author Flavia Proietti More articles by this author Zhenjie Wu More articles by this author Antonio Franco More articles by this author Linhui Wang More articles by this author Vitaly Margulis More articles by this author Raj Bhanvadia More articles by this author Firas Abdollah More articles by this author Marco Finati More articles by this author Alessandro Antonelli More articles by this author Francesco Ditonno More articles by this author Nirmish Singla More articles by this author Stephan Broenimann More articles by this author Ithaar H. Derweesh More articles by this author Dhruv Puri More articles by this author Soroush Rais-Bahrami More articles by this author Sol C. Moon More articles by this author Matteo Ferro More articles by this author Marco Tozzi More articles by this author Francesco Porpiglia More articles by this author Enrico Checcucci More articles by this author Andreas Correa More articles by this author Emma Helstrom More articles by this author Mark L. Gonzalgo More articles by this author Dinno F. Mendiola More articles by this author Sisto Perdonà More articles by this author Antonio Tufano More articles by this author Benjamine M. Eilender More articles by this author Reza Mehrazin More articles by this author Courtney Yong More articles by this author Chandru P. Sundaram More articles by this author Alireza Ghoreifi More articles by this author Hooman Djaladat More articles by this author Riccardo Autorino More articles by this author Giuseppe Simone More articles by this author Expand All Advertisement PDF downloadLoading ...