7124 POSTER Adjuvant Radiotherapy With or Without Chemotherapy in Patients With Stage lll/IV Transitional Cell Carcinoma of the Upper Urinary Tract And/or Positive Resection Margin

Jwa, Eunkyoung; Kim, Y.S.; Kim, C.S.; Ahn, Hye Young; Lee, J.L.; Lee, S.W.; Kim, J.H.; Choi, Eun Kyung; Ahn, S.D.

doi:10.1016/s0959-8049(11)72039-1

Cited by 2 publications

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“…(2) Tumor-specific factors: Mathieu et al 9 revealed that stage, multifocality, and lymph node metastasis were possible risk factors for the recurrence of tumors following surgery for UTUC, whereas Vartolomei et al 13 reported that tumor necrosis and LVI have a significant impact on the risk of tumor recurrence. (3) Treatment-specific factors: Recently, Jwa et al 27 reported that adjuvant radiotherapy may significantly decrease the risks of locoregional and disease recurrence. Shariat et al 12 found that adjuvant chemotherapy had a significant impact on lowering the risk of tumor recurrence.…”

Section: Discussionmentioning

confidence: 99%

Impact of tumor architecture on disease recurrence and cancer-specific mortality of upper tract urothelial carcinoma treated with radical nephroureterectomy

et al. 2017

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Upper tract urinary carcinoma (UTUC) is a relatively uncommon but aggressive disease. Recent publications have assessed the prognostic significance of tumor architecture in UTUC, but there is still controversy regarding the significance and importance of tumor architecture on disease recurrence. We retrospectively reviewed the medical records of 101 patients with clinical UTUC who had undergone surgery. Univariate and multivariate analyses were conducted to identify factors associated with disease recurrence and cancer-specific mortality. As our single center study and the limited sample size may influence the clinical significance, we further quantitatively combined the results with those of existing published literature through a meta-analysis compiled from searching several databases. At a median follow-up of 41.3 months, 25 patients experienced disease recurrence. Spearman's correlation analysis showed that tumor architecture was found to be positively correlated with the tumor location and the histological grade. Kaplan-Meier curves showed that patients with sessile tumor architecture had significantly poor recurrence free survival (RFS) and cancer specific survival (CSS). Furthermore, multivariate analysis suggested that tumor architecture was independent prognostic factors for RFS (Hazard ratio, HR = 2.648) and CSS (HR = 2.072) in UTUC patients. A meta-analysis of investigating tumor architecture and its effects on UTUC prognosis was conducted. After searching PubMed, Medline, Embase, Cochrane Library and Scopus databases, 17 articles met the eligibility criteria for this analysis. The eligible studies included a total of 14,368 patients and combined results showed that sessile tumor architecture was associated with both disease recurrence with a pooled HR estimate of 1.454 and cancer-specific mortality with a pooled HR estimate of 1.416. Tumor architecture is an independent predictor for disease recurrence after radical nephroureterectomy for UTUC. Therefore, closer surveillance is necessary, especially in patients with sessile tumor architecture.

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Section: Discussionmentioning

confidence: 99%

Impact of tumor architecture on disease recurrence and cancer-specific mortality of upper tract urothelial carcinoma treated with radical nephroureterectomy

et al. 2017

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“…Li HZ et al’s [ 21 ] studies showed that adjuvant radiotherapy significantly improved 5-year RFS compared with partial ureterectomy alone, and partial ureterectomy combined with adjuvant radiotherapy did not significantly improve 5-year RFS compared with radical nephroureterectomy. Jwa E et al [ 10 ] showed that adjuvant radiotherapy could improve the local control rate and could reduce the bladder recurrence rate but did not improve OS or PFS. Chang YH et al’s [ 22 ] study yielded similar results.…”

Section: Discussionmentioning

confidence: 99%

“…However, the efficacy of postoperative radiotherapy in UTUC is unclear due to the rarity of the disease. Recent studies have shown that adjuvant radiotherapy can decrease the 3-year local recurrence rate (LRR) from 39 to 11% and improve overall survival [ 10 , 11 ]. Liu et al explored the potential safety and effectiveness of radiotherapy as a curative treatment for UTUC patients who cannot undergo surgery for several reasons, such as unresectable disease, old age, and multiple comorbidities [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Postoperative adjuvant radiotherapy for patients with upper tract urothelial carcinoma (UTUC) who underwent kidney-sparing surgery (KSS): a single-center study

Guan

Wang

et al. 2023

Radiat Oncol

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Objective The purpose of this study was to evaluate the efficacy of postoperative adjuvant radiotherapy for patients with upper tract urothelial carcinoma (UTUC) who underwent kidney-sparing surgery (KSS). Methods We retrospectively reviewed the clinical records of 31 patients with primary UTUC who underwent kidney-sparing surgery (KSS) and who were treated with adjuvant radiotherapy at our center between October 1998 and May 2017. Statistical analyses were performed with SPSS 23.0. The primary endpoints of this study included overall survival (OS) and local recurrence-free survival (LRFS); the secondary endpoints were disease-free survival (DFS) and treatment-related toxicity. Results The median follow-up was 58.4 months (range, 12.7-185.3 months), and the median local recurrence time was 59.0 months (range, 7.0-185 months). All of the patients completed radiotherapy on schedule, and no grade 3–4 late-stage reaction was observed. The estimated 5-year and 10-year OS, DFS and LRFS rates of the patients were 64.0%, 61.1%, 69.6% and 48.0%, 40.9%, 64.6%, respectively. Univariate analysis showed that age (χ2 = 4.224, P = 0.040), R0 resection (χ2 = 3.949, P = 0.047), and early stage (I + II) (χ2 = 6.515, P = 0.011) were associated with good OS; DFS benefit in early stage patients (χ2 = 6.151, P = 0.013) and age<70 years old (χ2 = 5.091, P = 0.024). Patients with distal ureteral segments had better LRFS than patients with proximal ureteral cancer (χ2 = 5.248, P = 0.022). However, multivariate analysis showed that age was the only factor of OS (χ2 = 4.099, P = 0.043). Conclusion Adjuvant radiotherapy is safe and tolerated, and LRFS was superior in middle and distal ureteral cancer than in proximal ureteral cancer.

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7124 POSTER Adjuvant Radiotherapy With or Without Chemotherapy in Patients With Stage lll/IV Transitional Cell Carcinoma of the Upper Urinary Tract And/or Positive Resection Margin

Cited by 2 publications

References 0 publications

Impact of tumor architecture on disease recurrence and cancer-specific mortality of upper tract urothelial carcinoma treated with radical nephroureterectomy

Impact of tumor architecture on disease recurrence and cancer-specific mortality of upper tract urothelial carcinoma treated with radical nephroureterectomy

Postoperative adjuvant radiotherapy for patients with upper tract urothelial carcinoma (UTUC) who underwent kidney-sparing surgery (KSS): a single-center study

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