MP2-19 HIGH RISK UPPER URINARY TRACT UROTHELIAL CARCINOMA PATIENTS WITH LYMPHOVASCULAR INVASION HAVE THE ADVANTAGE OF ADJUVANT CHEMOTHERAPY

You have accessJournal of UrologyBladder Cancer: Upper Tract TCC I1 Apr 2015MP2-19 HIGH RISK UPPER URINARY TRACT UROTHELIAL CARCINOMA PATIENTS WITH LYMPHOVASCULAR INVASION HAVE THE ADVANTAGE OF ADJUVANT CHEMOTHERAPY Shinichi Yamashita, Akihiro Ito, Ichiro Shintaku, Tatsuo Tochigi, Fumihiko Soma, Takashige Namima, Shinnosuke Katoh, Shozo Ota, Atsushi Kyan, Kazuhiko Orikasa, Kenji Numahata, Atsushi Takeda, Masataka Aizawa, Naomasa Ioritani, Yasuhiro Kaiho, Haruo Nakagawa, and Yoichi Arai Shinichi YamashitaShinichi Yamashita More articles by this author , Akihiro ItoAkihiro Ito More articles by this author , Ichiro ShintakuIchiro Shintaku More articles by this author , Tatsuo TochigiTatsuo Tochigi More articles by this author , Fumihiko SomaFumihiko Soma More articles by this author , Takashige NamimaTakashige Namima More articles by this author , Shinnosuke KatohShinnosuke Katoh More articles by this author , Shozo OtaShozo Ota More articles by this author , Atsushi KyanAtsushi Kyan More articles by this author , Kazuhiko OrikasaKazuhiko Orikasa More articles by this author , Kenji NumahataKenji Numahata More articles by this author , Atsushi TakedaAtsushi Takeda More articles by this author , Masataka AizawaMasataka Aizawa More articles by this author , Naomasa IoritaniNaomasa Ioritani More articles by this author , Yasuhiro KaihoYasuhiro Kaiho More articles by this author , Haruo NakagawaHaruo Nakagawa More articles by this author , and Yoichi AraiYoichi Arai More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.142AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Most upper urinary tract urothelial carcinomas (UTUCs) are invasive and advanced with a poor prognosis. Adjuvant chemotherapy is expected to improve their survival. However, the efficacy of and the indication for adjuvant chemotherapy for UTUC remain controversial. In this study, the effect of adjuvant chemotherapy was evaluated retrospectively. METHODS Patients underwent radical nephroureterectomy for UTUC in 12 institutions of the Tohoku Urological Evidence-Based Medicine Study Group between 2000 and 2011. Patients diagnosed with pathologic T3 and T4 were included in this study. Those who received neoadjuvant chemotherapy were excluded. Survival was analyzed using the Kaplan-Meier method and the log-rank test. RESULTS A total of 233 patients were eligible for this study. The median follow-up was 36 months. The cancer-specific survival rates at 1, 2, and 5 years were 90%, 76%, and 58%, respectively. Of the 233 patients, 39 were pathologic node-positive. The patients with pN+ had an unfavorable prognosis and did not benefit from adjuvant chemotherapy. Of the 194 patients with pN0/x, 123 had lymphovascular invasion. Patients with lymphovascular invasion had worse survival rates than patients without lymphovascular invasion. A total of 22 patients without and 59 patients with lymphovascular invasion received adjuvant chemotherapy. Interestingly, whereas adjuvant chemotherapy did not lead to any improvement in survival in patients without lymphovascular invasion, it did have a significant impact on cancer-specific and overall survival rates of patients with lymphovascular invasion. CONCLUSIONS Lymph node involvement or lymphovascular invasion was a negative prognostic factor for high risk UTUC. Adjuvant chemotherapy improved the survival of patients with lymphovascular invasion, suggesting that patients with lymphovascular invasion might benefit from adjuvant chemotherapy. Larger prospective trials need to confirm this finding. On the other hand, adjuvant chemotherapy for patients with lymph node involvement should be examined further. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e18 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.Metrics Author Information Shinichi Yamashita More articles by this author Akihiro Ito More articles by this author Ichiro Shintaku More articles by this author Tatsuo Tochigi More articles by this author Fumihiko Soma More articles by this author Takashige Namima More articles by this author Shinnosuke Katoh More articles by this author Shozo Ota More articles by this author Atsushi Kyan More articles by this author Kazuhiko Orikasa More articles by this author Kenji Numahata More articles by this author Atsushi Takeda More articles by this author Masataka Aizawa More articles by this author Naomasa Ioritani More articles by this author Yasuhiro Kaiho More articles by this author Haruo Nakagawa More articles by this author Yoichi Arai More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...