MP71-13 EFFICACY OF CHEMOTHERAPY ADMINISTRATION IN ELDERLY PATIENTS WITH METASTATIC UPPER TRACT UROTHELIAL CARCINOMA AFTER RADICAL NEPHROURETERECTOMY.

Abstract

You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma I1 Apr 2017MP71-13 EFFICACY OF CHEMOTHERAPY ADMINISTRATION IN ELDERLY PATIENTS WITH METASTATIC UPPER TRACT UROTHELIAL CARCINOMA AFTER RADICAL NEPHROURETERECTOMY. Keisuke Shigeta, Eiji Kikuchi, Keishiro Fukumoto, Nozomi Hayakawa, Takeo Kosaka, Akira Miyajima, and Mototsugu Oya Keisuke ShigetaKeisuke Shigeta More articles by this author , Eiji KikuchiEiji Kikuchi More articles by this author , Keishiro FukumotoKeishiro Fukumoto More articles by this author , Nozomi HayakawaNozomi Hayakawa More articles by this author , Takeo KosakaTakeo Kosaka More articles by this author , Akira MiyajimaAkira Miyajima More articles by this author , and Mototsugu OyaMototsugu Oya More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2269AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Our recent findings from a multi-institutional study showed that up to one-third of upper tract urothelial carcinoma (UTUC) patients did not receive any chemotherapeutic treatment (CTx) for disease recurrence after radical nephroureterectomy (RNU) due to their high age, poor performance status (PS), and comorbidity. However, some patients may not have the chance to receive effective systemic CTx simply because of their advanced age. In this study, we attempted to determine the influence of age on the outcomes of CTx in UTUC patients with disease recurrence following RNU. METHODS We identified a study population of 226 patients who developed disease recurrence after RNU during the past 15 years at our 14 Japanese institutions. To identify factors that were related to cancer-specific survival (CSS) and overall survival (OS), we performed multivariate analysis using a Cox proportional hazards regression model that included clinicopathological variables. We also analyzed the efficacy of systemic CTx in a subgroup of patients aged >75 years (yr). RESULTS After disease recurrence, 145 patients underwent systemic CTx while the remaining 81 received no systemic treatment. Patients aged >75 yr (n=81) tended to have poor PS (P<0.001) and bone metastasis at the time of disease relapse (P=0.028) compared with the younger patients (n=145), while the administration of adjuvant CTx was less frequent (14.8% in patients aged >75 yr vs. 42.1% in those <75 yr, P<0.001). Multivariate analysis in the overall population revealed that the salvage CTx setting was independently related to CSS as well as OS along with poor PS, the presence of liver metastasis, number of recurrence sites, and lymph node involvement in RNU specimens. Meanwhile, age was not selected as an independent factor. In the subgroup analysis on patients >75 yr, we found no significant difference in the clinicopathological backgrounds among patients who received systemic CTx (n=38) and their counterparts (n=43). However, CSS rates in patients with systemic CTx were 41.8% at 1 year and 18.6% at 2 years, while those without were significantly decreased to 10.2% and 6.8% (P=0.001), respectively. A similar difference could be observed in the estimated probability of OS among patients aged >75 yr. CONCLUSIONS Survival rates are significantly higher in patients receiving salvage systemic CTx regardless of their age. Age is not a key indicator for selecting candidates for systemic CTx with disease recurrence after RNU. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e950-e951 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Keisuke Shigeta More articles by this author Eiji Kikuchi More articles by this author Keishiro Fukumoto More articles by this author Nozomi Hayakawa More articles by this author Takeo Kosaka More articles by this author Akira Miyajima More articles by this author Mototsugu Oya More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...