The Impact of Preoperative Severe Renal Insufficiency on Poor Postsurgical Oncological Prognosis in Patients with Urothelial Carcinoma

Momota, Masaki; Tokui, Noriko; Sato, Tetsumi; Yamamoto, Hayato; Tobisawa, Yuki; Yoneyama, T.; Yoneyama, Takahiro; Hashimoto, Yasuhiro; Koie, Takuya; Narita, Satoshi; Kawaguchi, Toshiaki; Οhyama, Chikara

doi:10.1016/j.euf.2018.03.003

Cited by 42 publications

(36 citation statements)

References 30 publications

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“…The follow‐up protocol in the Taiwan and Japan cohorts is as disclosed in previous studies . The end‐point of this study was to observe the natural course of UTUC within 5 years between these two groups.…”

Section: Methodsmentioning

confidence: 99%

“…The follow-up protocol in the Taiwan and Japan cohorts is as disclosed in previous studies. 1,4 The endpoint of this study was to observe the natural course of UTUC within 5 years between these two groups. The oncologic outcomes we observed after nephroureterectomy were IVR, SR (including regional recurrence and distant metastasis defined by urothelial carcinoma recurrence outside the residual urinary tract) and cancer-specific death within 5 years.…”

Section: Methodsmentioning

confidence: 99%

“…There is an unusual presentation of high prevalence and female predominance for upper UTUC in the Taiwan and China area . In other Asian areas, such as Japan and Korea, European and American countries, the male:female ratio is from 1.223:2.860 . However, the male:female ratio in Taiwan and China is 0.773:0.838 .…”

Section: Introductionmentioning

confidence: 98%

“…[1][2][3] In other Asian areas, such as Japan and Korea, European and American countries, the male:female ratio is from 1.223:2.860. [4][5][6][7] However, the male:female ratio in Taiwan and China is 0.773:0.838. [1][2][3] Several reports attributed this phenomenon to carcinogen exposure, such as arsenic and aristolochic acid.…”

Section: Introductionmentioning

confidence: 99%

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Unusual presentation of upper urinary tract urothelial carcinoma in Taiwan: Direct comparison from Taiwan‐Japan UTUC Collaboration Cohort

et al. 2020

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Objectives To carry out a comparison of upper urinary tract urothelial carcinoma characteristics and behavior between patients in Taiwan and Japan. Methods A Taiwan urinary tract urothelial carcinoma cohort was obtained from Kaohsiung Chang Gung Memorial Hospital, and a Japan urinary tract urothelial carcinoma cohort from Hirosaki University Hospital. The inclusion criteria were urinary tract urothelial carcinoma patients who underwent radical nephroureterectomy. Those who received perioperative chemotherapy were excluded. Finally, 765 patients in the Taiwan cohort and 325 in the Japan cohort were analyzed. The end‐point of this study was to study the natural course of urinary tract urothelial carcinoma within 5 years between these two groups. Results The main finding was that urinary tract urothelial carcinoma patients in Taiwan were younger (P < 0.001), more were women (P < 0.001), with low‐stage disease (P < 0.001), with more chronic kidney disease (P < 0.001), with less smoking history (P < 0.001), with more bladder cancer history (P = 0.002), with more multifocal (P < 0.001) and less high‐grade disease (P = 0.015), as well as less lymphovascular invasion (P < 0.001) and more squamous differentiation (P < 0.001). However, the multivariate Cox regression analysis showed no racial difference in oncologic outcome, such as intravesical recurrence, systemic recurrence or cancer‐specific death in primary and propensity‐matched cohorts. Bladder cancer history was found to be the most important factor predicting intravesical recurrences, whereas stage was strongly associated with systemic recurrence and cancer specific mortality. Conclusions The clinical characteristics of urinary tract urothelial carcinoma in Taiwan are significantly different from those of urinary tract urothelial carcinoma in Japan. However, there is no racial difference in stage‐specific oncologic outcome after standard nephroureterectomy.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Unusual presentation of upper urinary tract urothelial carcinoma in Taiwan: Direct comparison from Taiwan‐Japan UTUC Collaboration Cohort

et al. 2020

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“…We selected three courses of neoadjuvant GCb and this patient obtained the pathological complete response. Although inferior efficacy of a carboplatin‐based regimen has been suggested, our previous study showed a low toxicity GCb regimen facilitated in completion of NAC, prevention of the delay in RC, and resulted in a favorable oncological and QOL outcome . Therefore, neoadjuvant GCb might be an alternative option for MIBC patients with renal implement.…”

Section: Discussionmentioning

confidence: 94%

Robot‐assisted radical cystectomy in a patient with muscle‐invasive bladder cancer following radiotherapy for prostate cancer

et al. 2019

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Abbreviations & Acronyms GCb = gemcitabine plus carboplatin IMRT = intensity-modulated radiation therapy MIBC = muscle-invasive bladder cancer NAC = neoadjuvant chemotherapy PC = prostate cancer POD = postoperative day QOL = quality of life RARC = robot-assisted radical cystectomy RARP = robotic-assisted radical prostatectomy RC = radical cystectomy RT = radiotherapy Correspondence: ShingoIntroduction: Muscle-invasive bladder cancer following radiotherapy for prostate cancer is rare. We reported a case of muscle-invasive bladder cancer who underwent robot-assisted radical cystectomy following radiotherapy for prostate cancer. Case presentation: A 72-year-old man was referred to our division with a muscleinvasive bladder cancer. He had a history of intensity-modulated radiation therapy for localized prostate cancer. After three courses of platinum-based neoadjuvant chemotherapy, he obtained a radiologic complete response. He elected for robotassisted radical cystectomy, standard lymph node dissection, and intracorporeal ileal conduit urinary diversion. Pathological findings revealed no residual tumor within the bladder and residual tumor in the prostate. He had discharged without any complications; and quality of life had improved. Conclusion: A robot-assisted approach might be a potential option for well-selected patients with muscle-invasive bladder cancer who have previously received radiotherapy for localized prostate cancer.Although surgical treatment for patients with MIBC who have previously received RT for PC is challenging, this report indicates a robot-assisted approach might be a potential option for well-selected patients with MIBC who have previously received RT for localized PC.

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Multimodal kidney‐preserving approach in localised and locally advanced high‐risk upper tract urothelial carcinoma

et al. 2021

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Objectives: Multimodal kidney-preserving (MKP) strategies may be an option for patients with localised or locally advanced high-risk upper tract urothelial carcinoma (UTUC) who have a relative contraindication for nephroureterectomy (NU). Materials and methods:We studied patients with UTUC who were managed with MKP strategies, consisting of systemic anticancer therapy, with or without local/ topical strategies after endoscopic control of intraluminal tumours. Primary end points were overall survival (OS) and progression-free survival (PFS).Results: Fourteen patients received MKP treatment between August 2013 and April 2020. Median baseline estimated glomerular filtration rate was 43 mL/min/1.73m 2 .MKP was mainly pursued to avoid dialysis (10/14, 71%), followed by low performance status and/or comorbidities (2/14, 14%). All patients had received systemic therapy: chemotherapy (64%) and immunotherapy (36%). Endoscopic control and/or laser ablation was feasible in 7 (50%) patients. Calculated overall risk of non-organ confined disease was 35%. Predicted 2-year and 5-year relapse-free probability (RFP) was 74% (24-92%) and 62% (10-85%), respectively. Median follow-up was 31 months (95% CI: 22.6, NE), median OS was 48.1 months (95% CI: 48.1, NE) and 2-year OS probability was 0.89 (95% CI: 0.71, 1). Median metastases-free survival was 48.1 months (95% CI: 26.8, NE), median PFS was 22.4 months (95% CI: 15.6, NE) and 2-year PFS probability was 0.48 (0.26, 0.89). Conclusion:Management of high-risk localised or locally advanced UTUC with MKP strategies was associated with good tolerance, preservation of renal function, and comparable PFS and OS to predicted in vulnerable patients. Prospective studies with more patients are needed to evaluate these possible benefits relative to current standards.

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The Impact of Preoperative Severe Renal Insufficiency on Poor Postsurgical Oncological Prognosis in Patients with Urothelial Carcinoma

Cited by 42 publications

References 30 publications

Unusual presentation of upper urinary tract urothelial carcinoma in Taiwan: Direct comparison from Taiwan‐Japan UTUC Collaboration Cohort

Unusual presentation of upper urinary tract urothelial carcinoma in Taiwan: Direct comparison from Taiwan‐Japan UTUC Collaboration Cohort

Robot‐assisted radical cystectomy in a patient with muscle‐invasive bladder cancer following radiotherapy for prostate cancer

Multimodal kidney‐preserving approach in localised and locally advanced high‐risk upper tract urothelial carcinoma

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