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Chemo Benefits Patients After Nephroureterectomy in UTUC

Adjuvant chemo better than observation after radical nephroureterectomy for upper tract urothelial CA

male patient

FRIDAY, Jan. 6, 2017 (HealthDay News) -- For patients undergoing radical nephroureterectomy (RNU) for pT3/T4 and/or pN+ upper tract urothelial carcinoma (UTUC), adjuvant chemotherapy (AC) use is associated with an overall survival benefit, according to a study published online Jan. 3 in the Journal of Clinical Oncology.

Thomas Seisen, M.D., from Brigham and Women's Hospital in Boston, and colleagues identified 3,253 individuals within the National Cancer Database who received AC or observation after RNU for pT3/T4 and/or pN+ UTUC. Overall survival (OS) was compared for patients in the two treatment groups.

The researchers found that after RNU, 762 (23.42 percent) and 2,491 (76.58 percent) patients with pT3/T4 and/or pN+ UTUC received AC and observation, respectively. Median OS was significantly longer for AC versus observation (47.41 versus 35.78 months) in inverse probability of treatment weighting (IPTW)-adjusted Kaplan-Meier curves. For AC versus observation, the five-year IPTW-adjusted rates of OS were 43.90 and 35.85 percent, respectively. AC correlated with a significant OS benefit in IPTW-adjusted Cox proportional hazards regression analysis (hazard ratio, 0.77). Across all subgroups this benefit was consistent, with no significant heterogeneity of treatment effect.

"Although our results are limited by the usual biases related to the observational study design, we believe that the present findings should be considered when advising post-RNU management of advanced UTUC, pending level I evidence," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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