Recommended Citation
Seisen T, Jindal T, Karabon P, Sood A, Bellmunt J, Roupret M, Leow JJ, Vetterlein MW, Sun M, Alanee S, Choueiri TK, Trinh QD, Menon M, and Abdollah F. Efficacy of systemic chemotherapy plus radical nephroureterectomy for metastatic upper tract urothelial carcinoma. Eur Urol 2017; 71(5):714-718.
Document Type
Article
Publication Date
5-1-2017
Publication Title
European urology
Abstract
Given the growing body of evidence supporting the benefit of primary tumor control for a wide range of metastatic malignancies, we hypothesized that chemotherapy plus radical nephroureterectomy (RNU) is associated with an overall survival (OS) benefit compared to chemotherapy alone for metastatic upper tract urothelial carcinoma (mUTUC). Within the National Cancer Data Base (2004–2012), we identified 398 (38.4%) and 637 (61.6%) patients who received chemotherapy plus RNU and chemotherapy alone, respectively. Inverse probability of treatment weighting (IPTW)-adjusted Kaplan-Meier curves showed that 3-yr OS was 16.2% (95% confidence interval [CI] 12.1–20.3) for chemotherapy plus RNU and 6.4% (95%CI 4.1–8.7) for chemotherapy alone ( p < 0.001). In IPTW-adjusted Cox regression analysis, chemotherapy plus RNU was associated with a significant OS benefit (hazard ratio 0.70, 95% CI 0.61–0.80; p < 0.001). Despite the usual biases related to the observational study design, our findings show a net OS benefit for fit patients who received chemotherapy plus RNU for mUTUC relative to their counterparts treated with chemotherapy alone.
Medical Subject Headings
Aged; Antineoplastic Combined Chemotherapy Protocols; Bone Neoplasms; Carcinoma, Transitional Cell; Case-Control Studies; Combined Modality Therapy; Female; Humans; Kaplan-Meier Estimate; Kidney Neoplasms; Logistic Models; Lymph Nodes; Lymphatic Metastasis; Male; Middle Aged; Multivariate Analysis; Neoplasm Metastasis; Nephroureterectomy; Proportional Hazards Models; Ureteral Neoplasms
PubMed ID
27912971
Volume
71
Issue
5
First Page
714
Last Page
718
