دورية أكاديمية
Impact of pathological response on oncological outcomes in patients with upper tract urothelial cancer receiving neo-adjuvant chemotherapy.
| العنوان: | Impact of pathological response on oncological outcomes in patients with upper tract urothelial cancer receiving neo-adjuvant chemotherapy. |
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| المؤلفون: | Yu CC; Division of Urology, Department of Surgery, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, New Taipei City, Taiwan; School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan., Chang CH; Department of Urology, China Medical University and Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan., Fang JK; Department of Urology, China Medical University and Hospital, Taichung, Taiwan., Huang SK; Division of Urology, Department of Surgery, Chi Mei Medical Center, Taiwan; Department of Medical Science Industries, College of Health Sciences, Chang Jung Christian University, Tainan City, Taiwan; School of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan., Tseng WH; Division of Urology, Department of Surgery, Chi Mei Medical Center, Taiwan., Lee HY; School of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan., Yeh HC; School of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan; Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan., Chen IA; Division of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, Taiwan., Lin JT; Division of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, Taiwan., Chen PC; Department of Urology, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan., Cheong IS; Department of Urology, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan., Hsueh TY; Division of Urology, Department of Surgery, Taipei City Hospital Renai Branch, Taiwan; Department of Urology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan., Jiang YH; Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan., Lee YK; Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan., Chen WC; Department of Urology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan., Lo SH; Department of Urology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan., Lin PH; Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan., Wang SS; Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Applied Chemistry, National Chi Nan University, Nantou, Taiwan., Huang CY; Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan., Wu CC; Department of Urology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan; Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan., Tseng JS; Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan; Mackay Medical College, Taipei, Taiwan; Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan., Wu SY; Division of Urology, Department of Surgery, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, New Taipei City, Taiwan; School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan., Tsai YC; Division of Urology, Department of Surgery, Taipei Tzu Chi Hospital, The Buddhist Medical Foundation, New Taipei City, Taiwan; School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan. Electronic address: tsai1970523@yahoo.com.tw. |
| المصدر: | Journal of the Formosan Medical Association = Taiwan yi zhi [J Formos Med Assoc] 2023 Dec; Vol. 122 (12), pp. 1274-1281. Date of Electronic Publication: 2023 Jul 01. |
| نوع المنشور: | Journal Article; Multicenter Study |
| اللغة: | English |
| بيانات الدورية: | Publisher: Formosan Medical Association, Elsevier Country of Publication: Singapore NLM ID: 9214933 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 0929-6646 (Print) Linking ISSN: 09296646 NLM ISO Abbreviation: J Formos Med Assoc Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2003- : Singapore : Formosan Medical Association, Elsevier Original Publication: Taipei, Taiwan : Formosan Medical Association, [1991- |
| مواضيع طبية MeSH: | Carcinoma, Transitional Cell*/drug therapy , Carcinoma, Transitional Cell*/surgery , Urinary Bladder Neoplasms*, Humans ; Chemotherapy, Adjuvant ; Neoadjuvant Therapy ; Nephroureterectomy ; Retrospective Studies |
| مستخلص: | Purpose: The purpose of this study is to evaluate the rates of pathological complete response (ypT0N0/X) and pathological response (ypT1N0/X or less) in patients with upper tract urothelial cancer who were treated with neo-adjuvant chemotherapy and to examine their impact on oncological outcomes. Methods: This study is a multi-institutional retrospective analysis of patients with high-risk upper tract urothelial cancer who underwent neoadjuvant chemotherapy and radical nephroureterectomy between 2002 and 2021. Logistic regression analyses were used to investigate all clinical parameters for response after neoadjuvant chemotherapy. Cox proportional hazard models were performed to assess the effect of the response on the oncological outcomes. Results: A total of 84 patients with UTUC who received neo-adjuvant chemotherapy were identified. Among them, 44 (52.4%) patients received cisplatin-based chemotherapy, and 22 (26.2%) patients had a carboplatin-based regimen. The pathological complete response rate was 11.6% (n = 10), and the pathological response rate was 42.9% (n = 36). Multifocal tumors or tumors larger than 3 cm significantly reduced the odds of pathological response. In the multivariable Cox proportional hazard model, pathological response was independently associated with better overall survival (HR 0.38, p = 0.024), cancer-specific survival (HR 0.24, p = 0.033), and recurrence-free survival (HR 0.17, p = 0.001), but it was not associated with bladder recurrence-free survival (HR 0.84, p = 0.69). Conclusion: Pathological response after neo-adjuvant chemotherapy and radical nephroureterectomy is strongly associated with patient survival and recurrence, and it might be a good surrogate for evaluating the efficacy of neo-adjuvant chemotherapy in the future. Competing Interests: Conflicts of interest The authors have no conflicts of interest relevant to this article. (Copyright © 2023 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Chemotherapy; Neo-adjuvant; Oncological outcomes; Upper tract urothelial cancer |
| تواريخ الأحداث: | Date Created: 20230703 Date Completed: 20231220 Latest Revision: 20231220 |
| رمز التحديث: | 20231220 |
| DOI: | 10.1016/j.jfma.2023.06.003 |
| PMID: | 37400294 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 0929-6646 |
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| DOI: | 10.1016/j.jfma.2023.06.003 |