Outcomes of upper tract urothelial carcinoma with isolated lymph node involvement following surgical resection: implications for multi-modal management.

World Journal of Urology
Aryeh PelcovitsBoris Gershman

Abstract

There are limited data on the oncologic outcomes of upper tract urothelial carcinoma with isolated lymph node (LN) involvement (pN+ M0) following surgical resection. We examined pN+ M0 UTUC in a large, nationwide oncology dataset to characterize its natural history, describe trends in utilization of perioperative chemotherapy, and identify clinicopathologic features associated with survival. We identified 794 patients aged 18-89 years who underwent radical nephroureterectomy with lymph node dissection for pN+ M0 UTUC from 2006 to 2013 in the National Cancer Database. The associations of clinicopathologic features with overall survival (OS) were evaluated using Cox regression models, and a simplified risk score was created. Median follow-up among survivors was 39.5 months, during which time 555 (70%) patients died. Over the study period, neoadjuvant chemotherapy utilization increased from 6.7 to 14.2% (p = 0.002), while adjuvant chemotherapy utilization remained stable (42.7 to 44.3%; p = 0.86). One-, 5-, and 8-year OS rates were 63.7%, 24.2%, and 18.7%, respectively. On multivariable analysis, older age, larger tumor size, higher pT stage, positive surgical margins, number of positive LNs, and non-receipt of adjuvant chemothera...Continue Reading

References

Mar 5, 2003·BJU International·C TerroneS Rocca Rossetti
Jul 13, 2004·Urology·Yoshinori ShirasakiHiromi Kumon
Jan 22, 2009·Cancer·Vitaly MargulisUNKNOWN Upper Tract Urothelial Carcinoma CollaborationThe Upper Tract Urothelial Carcinoma Collaboration
May 21, 2014·BJU International·Riaz J KarmaliJose A Karam
Jan 4, 2017·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Thomas SeisenSteven L Chang
Jan 10, 2017·Urologic Oncology·Andrew CohenSangtae Park
Oct 7, 2017·Journal of the National Comprehensive Cancer Network : JNCCN·Philippe E SpiessLisa A Gurski

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