Do metastatic upper tract urothelial carcinoma and bladder carcinoma have similar clinical responses to systemic chemotherapy? A Japanese multi-institutional experience

被引：17

作者：

Kikuchi, Eiji ^{[1
]}

Miyazaki, Jun ^{[2
]}

Yuge, Kazuyuki ^{[1
]}

Hagiwara, Masayuki ^{[1
]}

Ichioka, Daishi ^{[2
]}

Inoue, Takamitsu ^{[3
]}

Kageyama, Susumu ^{[4
]}

Sugimoto, Mikio ^{[5
]}

Mitsuzuka, Koji ^{[6
]}

Matsui, Yoshiyuki ^{[7
]}

Yamamoto, Shingo ^{[8
]}

Kinoshita, Hidefumi ^{[9
]}

Wakeda, Hironobu ^{[10
]}

Hanai, Kazuya ^{[11
]}

Nishiyama, Hiroyuki ^{[2
,12
]}

机构：

[1] Keio Univ, Sch Med, Dept Urol, Tokyo, Japan

[2] Univ Tsukuba, Fac Med, Dept Urol, 1-1-1 Tennodai, Tsukuba, Ibaraki 305, Japan

[3] Akita Univ, Sch Med, Dept Urol, Akita 010, Japan

[4] Shiga Univ Med Sci, Dept Urol, Otsu, Shiga 52021, Japan

[5] Kagawa Univ, Fac Med, Dept Urol, Takamatsu, Kagawa 760, Japan

[6] Tohoku Univ, Grad Sch Med, Dept Urol, Sendai, Miyagi 980, Japan

[7] Kyoto Univ, Grad Sch Med, Dept Urol, Kyoto, Japan

[8] Hyogo Coll Med, Dept Urol, Nishinomiya, Hyogo 6638501, Japan

[9] Kansai Med Univ, Dept Urol & Androl, Hirakata, Osaka, Japan

[10] Miyazaki Univ, Fac Med, Dept Urol, Miyazaki, Japan

[11] Tokai Univ Hosp, Dept Urol, Isehara, Kanagawa, Japan

[12] Tsukuba Crit Path Res & Educ Integrated Leading C, Tsukuba, Ibaraki, Japan

来源：

JAPANESE JOURNAL OF CLINICAL ONCOLOGY | 2016年 / 46卷 / 02期

关键词：

bladder; metastasis; outcome; urothelial carcinoma; upper urinary tract; UPPER URINARY-TRACT; TRANSITIONAL-CELL CARCINOMA; RADICAL NEPHROURETERECTOMY; RENAL-FUNCTION; PHASE-III; CANCER; RECURRENCE; ASSOCIATION; ELIGIBILITY; CYSTECTOMY;

D O I：

10.1093/jjco/hyv180

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objective: There has been no clear evidence supporting similar chemo-responses for upper and lower urothelial carcinomas. Methods: We conducted a multicenter retrospective cohort study to analyze urothelial carcinoma patients who underwent systemic chemotherapy at 17 centers from 2004 to 2010. A total of 298 patients with either urothelial carcinoma of the bladder (N = 151) or upper tract urothelial carcinoma (N = 147) were included. Differences in tumor location (urothelial carcinoma of the bladder vs. upper tract urothelial carcinoma) were evaluated in relation to the patient backgrounds and clinical responses to systemic chemotherapy. Results: Overall 216 patients were treated with cisplatin-based chemo-regimens (gemcitabine and cisplatin in 92, or methotrexate, vinblastine, adriamycin and cisplatin/methotrexate, epirubicin and cisplatin in 124). Among 186 initially metastatic patients, the incidences of lung metastasis and liver metastasis were 39.2 and 34.1%, respectively, in upper tract urothelial carcinoma patients, and were significantly higher than those with urothelial carcinoma of the bladder (22.4% for lung; 8.4% for liver metastasis). Among 112 post-surgical recurrent/metastatic patients, age was significantly higher and estimated glomerular filtration rate at baseline was significantly lower in upper tract urothelial carcinoma patients than those with urothelial carcinoma of the bladder. No significant differences were observed in overall clinical response rates for systemic chemotherapy between urothelial carcinoma of the bladder (45.8%) and upper tract urothelial carcinoma (38%) in initially metastatic patients or between urothelial carcinoma of the bladder (43.2%) and upper tract urothelial carcinoma (44.1%) in post-surgical recurrent/metastatic patients. Tumor location was not independently associated with cancer-specific survival in either initially metastatic or post-surgical recurrent/metastatic urothelial carcinoma patients. Conclusions: No significant difference was observed in response rates of urothelial carcinoma of the bladder and upper tract urothelial carcinoma to systemic chemotherapy, suggesting that a similar chemo-regimen can be applied to metastatic urothelial carcinoma patients regardless of tumor location (upper vs. lower).

引用

页码：163 / 169

页数：7

共 28 条

[1]

[Anonymous], 2014, UROL ONCOL

[2]

[Anonymous], J UROL

[3] The combination of gemcitabine and carboplatin as first-line treatment in patients with advanced urothelial carcinoma - A Phase II study of the Hellenic Cooperative Oncology Group [J].