MP58-18 OUTCOME OF METASTATIC UROTHELIAL CARCINOMA IN GC ERA: PROGNOSTIC FACTORS FROM REAL-WORLD CLINICAL PRACTICE IN JAPAN

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive II1 Apr 2015MP58-18 OUTCOME OF METASTATIC UROTHELIAL CARCINOMA IN GC ERA: PROGNOSTIC FACTORS FROM REAL-WORLD CLINICAL PRACTICE IN JAPAN Junji Ishizaki, Takashige Abe, Keita Minami, Ryuji Matsumoto, Toru Harabayashi, Ataru Sazawa, Tango Mochizuki, Satoshi Chiba, Tomoshige Akino, Masahi Murakumo, Naoto Miyajima, kunihiko Tsuchiya, Satoru Maruyama, and Nobuo Shinohara Junji IshizakiJunji Ishizaki More articles by this author , Takashige AbeTakashige Abe More articles by this author , Keita MinamiKeita Minami More articles by this author , Ryuji MatsumotoRyuji Matsumoto More articles by this author , Toru HarabayashiToru Harabayashi More articles by this author , Ataru SazawaAtaru Sazawa More articles by this author , Tango MochizukiTango Mochizuki More articles by this author , Satoshi ChibaSatoshi Chiba More articles by this author , Tomoshige AkinoTomoshige Akino More articles by this author , Masahi MurakumoMasahi Murakumo More articles by this author , Naoto MiyajimaNaoto Miyajima More articles by this author , kunihiko Tsuchiyakunihiko Tsuchiya More articles by this author , Satoru MaruyamaSatoru Maruyama More articles by this author , and Nobuo ShinoharaNobuo Shinohara More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2157AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Combinations of gemcitabine plus cisplatin (GC) or methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) are established as the standard induction regimens for metastatic urothelial carcinoma. However, most patients become refractory to treatment and, at present, optimal treatment in the second-line setting has not been determined. Clinicians treat this difficult disease with the use of salvage chemotherapy, bone-modifying agents in patients with bone metastasis, or the resection of metastasis. The present study investigated prognostic factors of metatstatic urothelial carcinoma in Japanese real-world clinical practice in the GC era. METHODS A total of 225 patients with metastatic urothelial carcinoma undergoing systemic chemotherapy between 2000 and 2013 at seven hospitals were included in the present study. The GC regimen was administered as induction chemotherapy to 128 patients, while MVAC or its modified regimen was given to 71 patients. Of the 225 patients, 117 underwent at least two different regimens during treatment and 25 patients underwent resection of metastases, aiming to improve the outcome. The relationship between clinical characteristics and survival was analyzed using the Cox proportional hazards model. The characteristics analyzed were age, sex, ECOG performance status, primary site, pathology of primary site, hemoglobin levels, LDH levels, CRP levels, corrected calcium levels, eGFR levels, history of prior chemotherapy, resection of primary site, metastatic sites, number of metastatic organs, and resection of metastasis. RESULTS The median survival time was 17 months (95% confidence interval: 14-20 months) for 225 patients. Using a multivariate model, female sex (HR=0.509, p=0.0007), ECOG-PS0 at presentation (HR=0.463, p=0.0002), Hb level of more than 10 g/dL (HR=0.458, p=0.0034), single organ metastasis (HR=0.565, p=0.0012), and resection of metastatsis (HR=0.447, p=0.0043) were significant independent predictors of prolonged survival. CONCLUSIONS A more favorable PS at presentation, normal Hb level, single organ metastasis, and resection of metatstasis were favorable prognostic factors. In addition, a female sex was associated with long-term disease control. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e728 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Junji Ishizaki More articles by this author Takashige Abe More articles by this author Keita Minami More articles by this author Ryuji Matsumoto More articles by this author Toru Harabayashi More articles by this author Ataru Sazawa More articles by this author Tango Mochizuki More articles by this author Satoshi Chiba More articles by this author Tomoshige Akino More articles by this author Masahi Murakumo More articles by this author Naoto Miyajima More articles by this author kunihiko Tsuchiya More articles by this author Satoru Maruyama More articles by this author Nobuo Shinohara More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...