Renal safety and efficacy of cisplatin-based chemotherapy in patients with a solitary kidney after nephroureterectomy for urothelial carcinoma of the upper urinary tract

Joung, Jae Young; Seo, Ho Kyung; Cho, In-Chang; Chung, Hyun Sung; Chung, Jinsoo; Lee, Kang Hyun

doi:10.1007/s00280-010-1349-2

Cited by 17 publications

(6 citation statements)

References 25 publications

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“…However, the majority of patients with a solitary kidney underwent cisplatin-based chemotherapy without serious adverse events20. We also believe that nephrotoxicity to the single renal unit is not a major concern in adjuvant chemotherapy.…”

Section: Discussionmentioning

confidence: 91%

The Efficacy of Adjuvant Chemotherapy for Locally Advanced Upper Tract Urothelial Cell Carcinoma

Kim¹,

Oh²,

Rhew³

2013

J. Cancer

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Objective: To evaluate the efficacy of adjuvant cisplatin-based chemotherapy for locally advanced upper tract urothelial cell carcinoma (UTUC) following radical nephroureterectomy with bladder cuff resection (RNU) in terms of survival and recurrence.Materials and methods: Between January 2000 and January 2013, among 145 patients with upper tract urothelial cell carcinoma, a total of 65 patients with locally advanced UTUC (a diagnosis of pT3 or pT4 or pT1-2N1-3) underwent RNU. Of these 65 patients, 36 patients received at least three cycles of adjuvant gemcitabine plus cisplatin chemotherapy and the remaining 29 patient did not receive adjuvant chemotherapy. Clinical characteristics, bladder recurrence, distant metastasis, and cancer-specific survival were retrospectively reviewed.Results: The mean age of the 65 patients was 60.4 (range, 37-87) years and the median follow-up period was 34 (range, 12-114) months. Patent demographics were not statistically different between the two groups. During the follow-up period, 14 patients (21.5%) experienced distant metastasis; 8 (8/36, 22.2%) patients who had undergone adjuvant chemotherapy and 6 (6/29, 20.7%) patients who did not. Bladder recurrence was noted in 17 patients (26.2%), 5 (5/36, 13.9%) of whom received adjuvant chemotherapy while the remaining 12 (12/29, 41.4%) did not. Kaplan-Meire and multivariate analysis showed that the incidence of bladder recurrence was significantly higher in patients who did not undergo adjuvant chemotherapy, and cancer specific survival was not significantly associated with adjuvant chemotherapy.Conclusions: Adjuvant chemotherapy for locally advanced UTUC can prevent bladder recurrence, but has a minimal effect on cancer-specific survival.

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Section: Discussionmentioning

confidence: 91%

The Efficacy of Adjuvant Chemotherapy for Locally Advanced Upper Tract Urothelial Cell Carcinoma

Kim¹,

Oh²,

Rhew³

2013

J. Cancer

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“…Although very few studies have examined the effect of cisplatin‐based adjuvant chemotherapy after RNU on renal function, rare cases of hemodialysis have been reported …”

Section: Systemic Chemotherapy and Othersmentioning

confidence: 99%

Evidenced‐based clinical practice guideline for upper tract urothelial carcinoma (summary – Japanese Urological Association, 2014 edition)

Oya

Kikuchi

2014

Int J of Urology

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Upper tract urothelial carcinoma is more rare than bladder cancer, although they are both categorized as urothelial carcinoma. Because of the low incidence, little clinical evidence is available regarding the treatment of the former. However, recently such evidence has slowly begun to accumulate. The guideline presented herein was compiled for the purpose of ensuring proper diagnosis and treatment by physicians involved in the treatment of upper tract urothelial carcinoma. We carefully selected 16 clinical questions essential for daily clinical practice and grouped them into four major categories: epidemiology, diagnosis, surgery and systemic chemotherapy/other matters. Related literature was searched using PubMed and Japan Medical Abstracts Society databases for articles published between 1987 and 2013. If the judgment was made on the basis of insufficient or inadequate evidence, the grade of recommendation was determined on the basis of committee discussions and resultant consensus statements. Here, we present a short English version of the original guideline, and overview its key clinical issues.

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“…However, Lene et al recently showed that renal cell carcinoma patients with surgically-induced CKD (CKD-S) have a relatively low risk of progressive renal function decline, whereas those with medically-induced CKD (CKD-M) have an increased risk [ 20 ]. In addition, a previous report from Korea showed that cisplatin-based chemotherapy was safe in the majority of patients who underwent nephroureterectomy [ 21 ]. It is plausible that the CKD-S patients, who underwent nephroureterectomy or who have ipsilateral hydronephrosis and an intact solitary-functioning kidney without medical comorbidities, have some potential endurance for nephrotoxicity in cisplatin-based chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

A comparison of nephrotoxicity between patients with a solitary-functioning kidney and those with bilateral-functioning kidneys in cisplatin-based chemotherapy for advanced urothelial carcinoma: a Japanese retrospective multi-institutional study

et al. 2018

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BackgroundTo compare the prevalence of nephrotoxicity between patients with a solitary-functioning kidney versus those with bilateral-functioning kidneys during the administration of cisplatin-based chemotherapy for advanced urothelial carcinoma.MethodsWe retrospectively analyzed 244 advanced urothelial carcinoma patients treated with cisplatin-based chemotherapy between 2004 and 2010 at 17 institutes in Japan. The 24 h creatinine clearance, Cockcroft–Gault formula, and estimated glomerular filtration rate equation (eGFR), were compared before all chemotherapies. The urinary tract function status was determined based on the data of nephroureterectomy, hydronephrosis, and relief of upper urinary tract obstruction. A total of 244 patients were divided into four groups according to their urinary tract functioning status and eGFR results, including bilateral-functioning kidneys with pretreatment eGFR ≥60 mL/min/1.73 m2 group (n = 83, 34.0%); a solitary-functioning kidney with pretreatment eGFR ≥60 mL/min/1.73 m2 group (n = 36, 14.8%); bilateral-functioning kidneys with pretreatment eGFR < 60 mL/min/1.73 m2 group (n = 45, 18.4%); and a solitary-functioning kidney with pretreatment eGFR < 60 mL/min/1.73 m2 group (n = 80, 32.8%).ResultsThe prevalence of nephrotoxicity with impaired eGFR of > 10% and 30% from baseline in the post-third-course of chemotherapy was significantly higher in patients with bilateral-functioning kidneys than in those with a solitary-functioning kidney, among patients with pretreatment eGFR < 60 mL/min/1.73 m2 (p = 0.023 and p = 0.026). During all courses of chemotherapy, the prevalence of nephrotoxicity with impaired eGFR of > 20% from baseline were significantly higher in patients with bilateral-functioning kidneys than those with a solitary-functioning kidney among patients with pretreatment eGFR < 60 mL/min/1.73 m2 (p = 0.034), whereas no significant difference was observed among patients with pretreatment eGFR ≥60 mL/min/1.73 m2.ConclusionsThe results suggest that cisplatin-based chemotherapy may have more nephrotoxicity in patients with bilateral-functioning kidneys than in those with a solitary-functioning kidney.Electronic supplementary materialThe online version of this article (10.1186/s12885-018-4186-z) contains supplementary material, which is available to authorized users.

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Renal safety and efficacy of cisplatin-based chemotherapy in patients with a solitary kidney after nephroureterectomy for urothelial carcinoma of the upper urinary tract

Abstract: Cisplatin-based chemotherapy can be administered in the majority of patients with UUT-UC with a solitary kidney after nephroureterectomy without inducing a serious AE, and provides acceptable efficacy.

Cited by 17 publications

References 25 publications

The Efficacy of Adjuvant Chemotherapy for Locally Advanced Upper Tract Urothelial Cell Carcinoma

The Efficacy of Adjuvant Chemotherapy for Locally Advanced Upper Tract Urothelial Cell Carcinoma

Evidenced‐based clinical practice guideline for upper tract urothelial carcinoma (summary – Japanese Urological Association, 2014 edition)

A comparison of nephrotoxicity between patients with a solitary-functioning kidney and those with bilateral-functioning kidneys in cisplatin-based chemotherapy for advanced urothelial carcinoma: a Japanese retrospective multi-institutional study

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