Adjuvant Chemotherapy For Upper Tract Transitional Cell Carcinoma: Results From The Upper Tract UCC Consortium

Main Category: Urology / Nephrology
Also Included In: Cancer / Oncology
Article Date: 06 Jun 2008 - 2:00 PDT

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ORLANDO, FL (UroToday.com) - Due to its relative low incidence, there is a paucity of literature regarding the use of adjuvant chemotherapy in the management of upper tract urothelial carcinoma (UTUC) and few clinical trials have addressed chemotherapy in this high risk population. Using a multi-institutional nephroureterectomy (NU) database, a group of international researchers sought to determine the prevalence and efficacy of adjuvant chemotherapy after NU for high risk UTTCC.

Using institutional NU databases from 12 urologic academic centers worldwide, they collected clinical and pathologic data on 1,363 patients who underwent NU for UT TCC. All pathologic slides were re-reviewed by genitourinary pathologist according to strict criteria. Univariable and multivariable Cox regression analyses were used to determine the effect of predictors on disease recurrence and cancer-specific survival (CSS).

Of the 1,363 patients in the collaborative database, 516 (38%) patients were candidates for adjuvant chemotherapy based on pathologic stage of pT3 or greater and/or node positive disease. Median age was 70 years (range 27-97), and 346 (67%) of patients were male. Pathologic stage distribution was as follows: 5%

They conclude that adjuvant chemotherapy is administered infrequently after NU for UTUC, with 25% of high risk (pT3-pT4 and/or pN+ M0) patients receiving chemotherapy. In this retrospective multi-institutional study, adjuvant chemotherapy has little impact on CSS after NU. The true impact of adjuvant chemotherapy on clinical outcomes after NU for UTUC awaits prospective collaborative clinical trials.

Presented by Theresa M Koppie, MD, et al., at the Annual Meeting of the American Urological Association (AUA) - May 17 - 22, 2008. Orange County Convention Center - Orlando, Florida, USA.

Reported by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS

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