MP82-11 SURVIVAL OUTCOMES IN NEOADJUVANT CHEMOTHERAPY FOR HIGH GRADE UPPER TRACT UROTHELIAL CARCINOMA: A NATIONALLY REPRESENTATIVE ANALYSIS

Abstract

You have accessJournal of UrologyBladder Cancer: Upper Tract Transitional Cell Carcinoma II (MP82)1 Apr 2020MP82-11 SURVIVAL OUTCOMES IN NEOADJUVANT CHEMOTHERAPY FOR HIGH GRADE UPPER TRACT UROTHELIAL CARCINOMA: A NATIONALLY REPRESENTATIVE ANALYSIS Aleem Khan*, Benjamin Taylor, Bashir Al Hussein Al Awamlh, Lina Posada Calderon, Jonathan Fainberg, Jonathan Shoag, and Douglas Scherr Aleem Khan*Aleem Khan* More articles by this author , Benjamin TaylorBenjamin Taylor More articles by this author , Bashir Al Hussein Al AwamlhBashir Al Hussein Al Awamlh More articles by this author , Lina Posada CalderonLina Posada Calderon More articles by this author , Jonathan FainbergJonathan Fainberg More articles by this author , Jonathan ShoagJonathan Shoag More articles by this author , and Douglas ScherrDouglas Scherr More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000974.011AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Upper tract urothelial carcinoma (UTUC) has considerably worse prognosis and treatment outcomes compared to urothelial carcinoma of the bladder. Additionally, studies into treatment efficacy for UTUC have typically been limited due to lower incidence of disease and relatively heterogenous patient populations. While neoadjuvant chemotherapy (NAC) has been proven to improve outcomes for bladder cancer, its efficacy has yet to be proven for UTUC. As primary studies for NAC use in UTUC are still underway, we sought to evaluate the current status of UTUC outcomes between patients who received NAC to those who did not using a contemporary national outcomes database. METHODS: The National Cancer Data Base was queried from 2004-2015 to identify subjects who underwent nephroureterectomy for UTUC. Kaplan-Meier method with log-rank test was performed to compare all-cause mortality between patients who received preoperative chemotherapy to those who did not at each pathologic (p) TNM stage group: T1-4N0, N+ and M+ disease. Associations for all-cause mortality were identified using an adjusted Cox regression analysis. RESULTS: A total of 10,315 chemo-eligible subjects were included in the analysis. A total of 296 (2.9%) of patients received NAC prior to NU. Kaplan Meier survival curves of the entire cohort demonstrated an overall survival advantage associated with administration of NAC (p=0.017). Stratified by clinical staging, subjects with non-organ confined tumors had improved overall survival outcomes with NAC administration (p=0.012). On multivariate analysis there was a statistically significant improvement in overall survival between in patients who received NAC. Of patients in the preoperative chemotherapy group who had clinically non-organ confined disease, 27.1% had organ confined disease at time of surgery compared to 1.4% of those who underwent surgery as initial therapy. CONCLUSIONS: In a contemporary cohort of subjects who underwent nephroureterectomy for UTUC, administration of NAC in patients with non-organ confined disease led to higher rates of pathologic downstaging and was associated with improved survival outcomes. Source of Funding: Weill Cornell Medical College - Department of Urology © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1250-e1250 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Aleem Khan* More articles by this author Benjamin Taylor More articles by this author Bashir Al Hussein Al Awamlh More articles by this author Lina Posada Calderon More articles by this author Jonathan Fainberg More articles by this author Jonathan Shoag More articles by this author Douglas Scherr More articles by this author Expand All Advertisement PDF downloadLoading ...