[Prospective controlled observation ofeffect of adjuvant chemotherapy onsurvival and prognosis ofhigh-risk upper tract urothelial carcinoma patients underwent radical nephroureterectomy].
Zhonghua Yi Xue Za Zhi
; 99(40): 3158-3163, 2019 Oct 29.
Article
in Zh
| MEDLINE
| ID: mdl-31694107
ABSTRACT
Objective:
To assess the oncologic outcomes of radical nephroureterectomy (RNU) combined with adjuvant chemotherapy (ACT) in patients with high risk upper tract urothelial carcinoma (UTUC).Methods:
From January 2014, all high-risk UTUC patients after RNU surgery were enrolled in this prospective comparative trial. And these patients were randomized to ACT group (Gemcitabine+Cisplatin three weeks regimen) and observing group. Cox proportional hazard modeling and Kaplan-Meier analysis were used to determine overall survival (OS), cancer specific survival (CSS) and disease-free survival (PFS) in the cohort.Results:
The median follow-up duration was36 months (range 6-54) in the ACT group (n=94) and 30 months (range 6-54) in the observing group (n=82). Oncologic outcomes of RNU treated high-risk UTUC patients were improved much significantly by ACT OS [P=0.0397, HR 1.39(0.91-1.75)], CSS [P=0.0255, HR 1.26(1.07-1.45)] and PFS [P=0.0033, HR 3.78(3.13-4.55)]. The further analysis in lymph node positive cohort displayed that median times of oncologic events were prolonged in the ACT group compared with the observing group OS (26.8mon vs 36.3mon, P=0.0255), CSS (28.2mon vs39.3mon, P=0.0197) and PFS (11.4mon vs 31.9mon, P=0.0018). Additionally in T3/4 cohort, the significant growth in the median times of OS (20.6mon vs 32.2mon, P=0.0183), CSS (21.9mon vs 38.4mon, P=0.0226) and PFS (13.9mon vs 36.3mon, P=0.0217) were observed in ACT group.Conclusion:
ACT could play the important synergistic role in improving the OS, CSS and PFS of high-risk UTUC patients after RNU.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Carcinoma, Transitional Cell
/
Nephroureterectomy
Type of study:
Clinical_trials
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
Language:
Zh
Journal:
Zhonghua Yi Xue Za Zhi
Year:
2019
Document type:
Article
Affiliation country:
China