Chemotherapy treatment patterns and survival outcomes in patients with visceral metastatic upper tract urothelial cell carcinoma.

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415 Background: Upper tract carcinoma (UTUC) is a poorly studied location amongst urothelial tumors. Treatment strategies are often extrapolated from bladder cancer and are not well defined. We aimed to retrospectively evaluate the chemotherapy (CT) treatment patterns and prognostic factors associated with outcome in patients (pts) with visceral metastatic UTUC. Methods: We collected clinical data on 102 UTUC pts treated at Dana-Farber Cancer Institute between Jan 2001 and Dec 2014. We focused our analysis on pts who recurred with visceral metastasis after radical nephroureterectomy and were subsequently treated with CT. Patients with lymph node only recurrence were excluded. Of 102 pts, 74 developed visceral metastasis from which 45 were treated. Overall survival (OS) was defined from date of first line CT for metastatic disease to date of death or censored at last follow up. Kaplan Meier method was used to estimate median OS. Cox regression model was used to summarize the association of OS and potential prognostic factors. Results: Overall, 45 pts received CT. The most common sites of metastases were lung (60%, n = 27), liver (49%, n = 22) and bone (36%, n = 16). 36 % of the pts (n = 16) received first line CT with cisplatin-based combinations. With a median follow up of 29.8 mo the median OS was 14.7 mo, with 32 pts having died at the time of analysis. PS, Hb ≤ 11 and other described known factors were analyzed as well as the impact on OS of the type of CT given cisplatin vs non cisplatin. 81% of the pts (n = 37) had PS < 2. PS 0-1 vs > 1 was included as an exploratory analysis being the number of pts small for grouping. Lower Hb was associated with shorter OS (p = 0.04). Cisplatin vs non cisplatin regimens had a trend on survival benefit in the analysis done in 11 pts (19,3 vs 13,2 mo). Further analysis is ongoing. Conclusions: Although only one third of patients were eligible, this study supports the use of cisplatin regimen to optimize survival in patients with UTUC and visceral metastasis. A significant correlation between Hb ≤11 and OS were observed. The exploratory analysis of PS 0-1 vs > 1 did not have an impact on survival. [Table: see text]