Adjuvant Chemotherapy for High Risk Upper Tract Urothelial Carcinoma: Results From the Upper Tract Urothelial Carcinoma Collaboration

Nicholas J. Hellenthal, Shahrokh F. Shariat, Vitaly Margulis, Pierre I. Karakiewicz, Marco Roscigno, Christian Bolenz, Mesut Remzi, Alon Weizer, Richard Zigeuner, Karim Bensalah, Casey K. Ng, Jay Raman, Eiji Kikuchi, Francesco Montorsi, Mototsugu Oya, Christopher G. Wood, Mario Fernandez, Christopher P. Evans, Theresa M. Koppie

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Abstract

Purpose: There is relatively little literature on adjuvant chemotherapy after radical nephroureterectomy in patients with upper tract urothelial carcinoma. We determined the incidence of adjuvant chemotherapy in high risk patients and the ensuing effect on overall and cancer specific survival. Materials and Methods: Using an international collaborative database we identified 1,390 patients who underwent nephroureterectomy for nonmetastatic upper tract urothelial carcinoma between 1992 and 2006. Of these cases 542 (39%) were classified as high risk (pT3N0, pT4N0 and/or lymph node positive). These patients were divided into 2 groups, including those who did and did not receive adjuvant chemotherapy, and stratified by gender, age group, performance status, and tumor grade and stage. Cox proportional hazard modeling and Kaplan-Meier analysis were used to determine overall and cancer specific survival in the cohorts. Results: Of high risk patients 121 (22%) received adjuvant chemotherapy. Adjuvant chemotherapy was more commonly administered in the context of increased tumor grade and stage (p <0.001). Median survival in the entire cohort was 24 months (range 0 to 231). There was no significant difference in overall or cancer specific survival between patients who did and did not receive adjuvant chemotherapy. However, age, performance status, and tumor grade and stage were significant predictors of overall and cancer specific survival. Conclusions: Adjuvant chemotherapy is infrequently used to treat high risk upper tract urothelial carcinoma after nephroureterectomy. Despite this finding it appears that adjuvant chemotherapy confers minimal impact on overall or cancer specific survival in this group.

Original languageEnglish (US)
Pages (from-to)900-906
Number of pages7
JournalJournal of Urology
Volume182
Issue number3
DOIs
StatePublished - Sep 1 2009

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Adjuvant Chemotherapy
Carcinoma
Survival
Neoplasms
Kaplan-Meier Estimate
Age Groups
Lymph Nodes
Databases
Incidence

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Hellenthal, N. J., Shariat, S. F., Margulis, V., Karakiewicz, P. I., Roscigno, M., Bolenz, C., ... Koppie, T. M. (2009). Adjuvant Chemotherapy for High Risk Upper Tract Urothelial Carcinoma: Results From the Upper Tract Urothelial Carcinoma Collaboration. Journal of Urology, 182(3), 900-906. https://doi.org/10.1016/j.juro.2009.05.011
Hellenthal, Nicholas J. ; Shariat, Shahrokh F. ; Margulis, Vitaly ; Karakiewicz, Pierre I. ; Roscigno, Marco ; Bolenz, Christian ; Remzi, Mesut ; Weizer, Alon ; Zigeuner, Richard ; Bensalah, Karim ; Ng, Casey K. ; Raman, Jay ; Kikuchi, Eiji ; Montorsi, Francesco ; Oya, Mototsugu ; Wood, Christopher G. ; Fernandez, Mario ; Evans, Christopher P. ; Koppie, Theresa M. / Adjuvant Chemotherapy for High Risk Upper Tract Urothelial Carcinoma : Results From the Upper Tract Urothelial Carcinoma Collaboration. In: Journal of Urology. 2009 ; Vol. 182, No. 3. pp. 900-906.
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title = "Adjuvant Chemotherapy for High Risk Upper Tract Urothelial Carcinoma: Results From the Upper Tract Urothelial Carcinoma Collaboration",
abstract = "Purpose: There is relatively little literature on adjuvant chemotherapy after radical nephroureterectomy in patients with upper tract urothelial carcinoma. We determined the incidence of adjuvant chemotherapy in high risk patients and the ensuing effect on overall and cancer specific survival. Materials and Methods: Using an international collaborative database we identified 1,390 patients who underwent nephroureterectomy for nonmetastatic upper tract urothelial carcinoma between 1992 and 2006. Of these cases 542 (39{\%}) were classified as high risk (pT3N0, pT4N0 and/or lymph node positive). These patients were divided into 2 groups, including those who did and did not receive adjuvant chemotherapy, and stratified by gender, age group, performance status, and tumor grade and stage. Cox proportional hazard modeling and Kaplan-Meier analysis were used to determine overall and cancer specific survival in the cohorts. Results: Of high risk patients 121 (22{\%}) received adjuvant chemotherapy. Adjuvant chemotherapy was more commonly administered in the context of increased tumor grade and stage (p <0.001). Median survival in the entire cohort was 24 months (range 0 to 231). There was no significant difference in overall or cancer specific survival between patients who did and did not receive adjuvant chemotherapy. However, age, performance status, and tumor grade and stage were significant predictors of overall and cancer specific survival. Conclusions: Adjuvant chemotherapy is infrequently used to treat high risk upper tract urothelial carcinoma after nephroureterectomy. Despite this finding it appears that adjuvant chemotherapy confers minimal impact on overall or cancer specific survival in this group.",
author = "Hellenthal, {Nicholas J.} and Shariat, {Shahrokh F.} and Vitaly Margulis and Karakiewicz, {Pierre I.} and Marco Roscigno and Christian Bolenz and Mesut Remzi and Alon Weizer and Richard Zigeuner and Karim Bensalah and Ng, {Casey K.} and Jay Raman and Eiji Kikuchi and Francesco Montorsi and Mototsugu Oya and Wood, {Christopher G.} and Mario Fernandez and Evans, {Christopher P.} and Koppie, {Theresa M.}",
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Hellenthal, NJ, Shariat, SF, Margulis, V, Karakiewicz, PI, Roscigno, M, Bolenz, C, Remzi, M, Weizer, A, Zigeuner, R, Bensalah, K, Ng, CK, Raman, J, Kikuchi, E, Montorsi, F, Oya, M, Wood, CG, Fernandez, M, Evans, CP & Koppie, TM 2009, 'Adjuvant Chemotherapy for High Risk Upper Tract Urothelial Carcinoma: Results From the Upper Tract Urothelial Carcinoma Collaboration', Journal of Urology, vol. 182, no. 3, pp. 900-906. https://doi.org/10.1016/j.juro.2009.05.011

Adjuvant Chemotherapy for High Risk Upper Tract Urothelial Carcinoma : Results From the Upper Tract Urothelial Carcinoma Collaboration. / Hellenthal, Nicholas J.; Shariat, Shahrokh F.; Margulis, Vitaly; Karakiewicz, Pierre I.; Roscigno, Marco; Bolenz, Christian; Remzi, Mesut; Weizer, Alon; Zigeuner, Richard; Bensalah, Karim; Ng, Casey K.; Raman, Jay; Kikuchi, Eiji; Montorsi, Francesco; Oya, Mototsugu; Wood, Christopher G.; Fernandez, Mario; Evans, Christopher P.; Koppie, Theresa M.

In: Journal of Urology, Vol. 182, No. 3, 01.09.2009, p. 900-906.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Adjuvant Chemotherapy for High Risk Upper Tract Urothelial Carcinoma

T2 - Results From the Upper Tract Urothelial Carcinoma Collaboration

AU - Hellenthal, Nicholas J.

AU - Shariat, Shahrokh F.

AU - Margulis, Vitaly

AU - Karakiewicz, Pierre I.

AU - Roscigno, Marco

AU - Bolenz, Christian

AU - Remzi, Mesut

AU - Weizer, Alon

AU - Zigeuner, Richard

AU - Bensalah, Karim

AU - Ng, Casey K.

AU - Raman, Jay

AU - Kikuchi, Eiji

AU - Montorsi, Francesco

AU - Oya, Mototsugu

AU - Wood, Christopher G.

AU - Fernandez, Mario

AU - Evans, Christopher P.

AU - Koppie, Theresa M.

PY - 2009/9/1

Y1 - 2009/9/1

N2 - Purpose: There is relatively little literature on adjuvant chemotherapy after radical nephroureterectomy in patients with upper tract urothelial carcinoma. We determined the incidence of adjuvant chemotherapy in high risk patients and the ensuing effect on overall and cancer specific survival. Materials and Methods: Using an international collaborative database we identified 1,390 patients who underwent nephroureterectomy for nonmetastatic upper tract urothelial carcinoma between 1992 and 2006. Of these cases 542 (39%) were classified as high risk (pT3N0, pT4N0 and/or lymph node positive). These patients were divided into 2 groups, including those who did and did not receive adjuvant chemotherapy, and stratified by gender, age group, performance status, and tumor grade and stage. Cox proportional hazard modeling and Kaplan-Meier analysis were used to determine overall and cancer specific survival in the cohorts. Results: Of high risk patients 121 (22%) received adjuvant chemotherapy. Adjuvant chemotherapy was more commonly administered in the context of increased tumor grade and stage (p <0.001). Median survival in the entire cohort was 24 months (range 0 to 231). There was no significant difference in overall or cancer specific survival between patients who did and did not receive adjuvant chemotherapy. However, age, performance status, and tumor grade and stage were significant predictors of overall and cancer specific survival. Conclusions: Adjuvant chemotherapy is infrequently used to treat high risk upper tract urothelial carcinoma after nephroureterectomy. Despite this finding it appears that adjuvant chemotherapy confers minimal impact on overall or cancer specific survival in this group.

AB - Purpose: There is relatively little literature on adjuvant chemotherapy after radical nephroureterectomy in patients with upper tract urothelial carcinoma. We determined the incidence of adjuvant chemotherapy in high risk patients and the ensuing effect on overall and cancer specific survival. Materials and Methods: Using an international collaborative database we identified 1,390 patients who underwent nephroureterectomy for nonmetastatic upper tract urothelial carcinoma between 1992 and 2006. Of these cases 542 (39%) were classified as high risk (pT3N0, pT4N0 and/or lymph node positive). These patients were divided into 2 groups, including those who did and did not receive adjuvant chemotherapy, and stratified by gender, age group, performance status, and tumor grade and stage. Cox proportional hazard modeling and Kaplan-Meier analysis were used to determine overall and cancer specific survival in the cohorts. Results: Of high risk patients 121 (22%) received adjuvant chemotherapy. Adjuvant chemotherapy was more commonly administered in the context of increased tumor grade and stage (p <0.001). Median survival in the entire cohort was 24 months (range 0 to 231). There was no significant difference in overall or cancer specific survival between patients who did and did not receive adjuvant chemotherapy. However, age, performance status, and tumor grade and stage were significant predictors of overall and cancer specific survival. Conclusions: Adjuvant chemotherapy is infrequently used to treat high risk upper tract urothelial carcinoma after nephroureterectomy. Despite this finding it appears that adjuvant chemotherapy confers minimal impact on overall or cancer specific survival in this group.

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