Perioperative chemotherapy in upper tract urothelial carcinoma: a comprehensive review.
World J Urol
; 35(9): 1401-1407, 2017 Sep.
Article
en En
| MEDLINE
| ID: mdl-28074261
ABSTRACT
PURPOSE:
To evaluate the role of neoadjuvant (NAC) and adjuvant chemotherapy (AC) in patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU).METHODS:
A comprehensive review of the current literature was performed searching for all studies investigating NAC and AC in UTUC in MEDLINE and https//clinicaltrials.gov , prior to April 2016. The following keywords were used "ureteral neoplasms," "urothelium," "ureter," "upper tract urothelial," "chemotherapy," "adjuvant," "neoadjuvant" and relevant variants.RESULTS:
No randomized trials investigated the role of AC or NAC for UTUC. There was one prospective study with n = 36 patients investigating AC with carboplatin-paclitaxel. We included 14 retrospective studies (four in the NAC and ten in the AC setting), with a total of 694 patients receiving cisplatin-based or non-cisplatin-based AC after RNU and 1437 patients undergoing RNU alone. We found that the current literature, mainly based on retrospective studies, suggests significant overall and cancer-specific survival benefits for AC in UTUC. NAC appears promising, with favorable pathologic response rates up to 14%.CONCLUSIONS:
Evidence is scarce for both NAC and AC use in UTUC. This comprehensive review suggests promising response rates for NAC and a survival benefit for patients treated with AC. Prospective randomized trials are needed to establish the role of AC and NAC in UTUC.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Neoplasias Ureterales
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Carcinoma de Células Transicionales
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Protocolos de Quimioterapia Combinada Antineoplásica
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Quimioterapia Adyuvante
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Terapia Neoadyuvante
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Neoplasias Renales
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Pelvis Renal
Tipo de estudio:
Clinical_trials
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Observational_studies
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Risk_factors_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
World J Urol
Año:
2017
Tipo del documento:
Article
País de afiliación:
Alemania