Impact of adjuvant chemotherapy in patients with pT3NanyM0 upper tract urothelial cancer following radical nephroureterectomy

32nd Annual EAU Congress, 24-28 March 2017, London, United Kingdom

179

Impact of adjuvant chemotherapy in patients with pT3NanyM0 upper tract urothelial cancer following radical nephroureterectomy Eur Urol Suppl 2017; 16(3);e305

Song W.1, Choi Y.H.1, Chung H.W.1, Lee C.U.1, Na J.P.1, Choi S.M.2, Sung H.H.1, Jeon H.G.1, Jeong B.C.1, Seo S.I.1, Jeon S.S.1, Choi H.Y.1, Lee H.M.1 1

Samsung Medical Center, Sungkyunkwan University School of Medicine, Dept. of Urology, Seoul, South Korea, 2Gyeongsang National University Hospital, Dept. of Urology, Jinju, South Korea INTRODUCTION & OBJECTIVES: Radical nephroureterectomy (RNU) may not be sufficient as monotherapy for patients with locally advanced upper tract urothelial carcinoma (UTUC). The efficacy of postoperative adjuvant chemotherapy (AC) in this setting remains controversial. In this study, we evaluate the efficacy of AC for patients with pT3NanyM0 UTUC following RNU in progression-free survival (PFS), cancer-specific survival (CSS) and overall survival (OS). MATERIAL & METHODS: We retrospectively reviewed records on 302 patients with pT3NanyM0 UTUC following RNU between February 1995 and May 2015. The clinicopathologic outcomes were compared according to the use of AC. PFS, CSS and OS rates were estimated using a survival curve adjusted for other variables that affected the each outcome. Predictors of PFS, CSS and OS were analyzed with a Cox regression model. RESULTS: Of 302 patients, 136 (45.0%) patients received AC after RNU and mean follow up period was 58.8months. Positive lymph node (12.7% vs 25.7%, p = 0.004), micropapillary UTUC (0.6% vs 4.4%, p = 0.049) and lymphovascular invasion (25.3% vs 37.5%, p =0.022) was more prominent in patients with AC. Survival curve showed that there was a significant difference in PFS (p =0.017) but not in CSS (p =0.449) and in OS (p =0.689) according to AC. On multivariate analysis, AC (HR: 0.64, 95% confidence interval (CI): 0.44-0.92, p = 0.017) was predictive factor of PFS, but not CSS (HR: 0.84, 95% CI: 0.54-1.31, p = 0.449) and OS (HR: 0.92, 95% CI: 0.61-1.39, p = 0.689)

Eur Urol Suppl 2017; 16(3);e305

32nd Annual EAU Congress, 24-28 March 2017, London, United Kingdom

179

Impact of adjuvant chemotherapy in patients with pT3NanyM0 upper tract urothelial cancer following radical nephroureterectomy Eur Urol Suppl 2017; 16(3);e306

CONCLUSIONS: AC improves PFS in patients with pT3NanyM0 UTUC following RNU, but has a minimal effect on CSS and OS.

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