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Comparison of neoadjuvant and adjuvant chemotherapy for upper tract urothelial carcinoma in real-world practice: a multicenter retrospective study.
- Source :
-
Japanese journal of clinical oncology [Jpn J Clin Oncol] 2023 Dec 07; Vol. 53 (12), pp. 1208-1214. - Publication Year :
- 2023
-
Abstract
- Background: Multiple studies have demonstrated the effectiveness of neoadjuvant chemotherapy and adjuvant chemotherapy in patients with upper tract urothelial carcinoma compared with surgery alone. However, no clinical trial has established the superiority of neoadjuvant chemotherapy or adjuvant chemotherapy in terms of perioperative outcomes.<br />Methods: We conducted a retrospective analysis encompassing 164 upper tract urothelial carcinoma patients who underwent radical nephroureterectomy and received perioperative chemotherapy. Of these patients, 65 (39.6%) and 99 (60.4%) received neoadjuvant chemotherapy and adjuvant chemotherapy, respectively. Recurrence-free survival and cancer-specific survival were computed using the Kaplan-Meier method. Additionally, we conducted Cox regression analyses to evaluate the risk factors for recurrence-free survival and cancer-specific survival.<br />Results: Pathological downstaging was seen in 37% of the neoadjuvant chemotherapy group. However, no pathological complete response was observed in this cohort. The Kaplan-Meier curves demonstrated significantly lower recurrence-free survival and cancer-specific survival in patients who received adjuvant chemotherapy. Multivariate Cox regression analysis revealed patients treated with adjuvant chemotherapy exhibited a marked association with inferior recurrence-free survival and cancer-specific survival.<br />Conclusion: Our study has suggested that neoadjuvant chemotherapy would be more effective in high-risk upper tract urothelial carcinoma patients compared with adjuvant chemotherapy.<br /> (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Subjects :
- Humans
Retrospective Studies
Neoadjuvant Therapy
Chemotherapy, Adjuvant
Urinary Bladder Neoplasms pathology
Carcinoma, Transitional Cell drug therapy
Carcinoma, Transitional Cell surgery
Carcinoma, Transitional Cell pathology
Ureteral Neoplasms drug therapy
Ureteral Neoplasms surgery
Ureteral Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1465-3621
- Volume :
- 53
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Japanese journal of clinical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 37647644
- Full Text :
- https://doi.org/10.1093/jjco/hyad118