Impact of perioperative chemotherapy on survival in patients with advanced primary urethral cancer: results of the international collaboration on primary urethral carcinoma
Jazyk angličtina Země Velká Británie, Anglie Médium print-electronic
Typ dokumentu časopisecké články, multicentrická studie, pozorovací studie
PubMed
25969370
DOI
10.1093/annonc/mdv230
PII: S0923-7534(19)31857-5
Knihovny.cz E-zdroje
- Klíčová slova
- adjuvant, chemoradiotherapy, chemotherapy, neoadjuvant, primary urethral carcinoma,
- MeSH
- adenokarcinom mortalita terapie MeSH
- adjuvantní chemoterapie metody MeSH
- chemoradioterapie metody MeSH
- cisplatina aplikace a dávkování MeSH
- cystektomie MeSH
- deoxycytidin aplikace a dávkování analogy a deriváty MeSH
- diverze moči MeSH
- fluoruracil aplikace a dávkování MeSH
- gemcitabin MeSH
- ifosfamid aplikace a dávkování MeSH
- Kaplanův-Meierův odhad MeSH
- karboplatina aplikace a dávkování MeSH
- karcinom z přechodných buněk mortalita terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mitomycin aplikace a dávkování MeSH
- nádory močové trubice mortalita terapie MeSH
- neoadjuvantní terapie metody MeSH
- paclitaxel aplikace a dávkování MeSH
- paklitaxel vázaný na albumin aplikace a dávkování MeSH
- perioperační péče MeSH
- přežití bez známek nemoci MeSH
- protokoly protinádorové kombinované chemoterapie terapeutické užití MeSH
- retrospektivní studie MeSH
- senioři MeSH
- spinocelulární karcinom mortalita terapie MeSH
- uretra chirurgie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
- Názvy látek
- cisplatina MeSH
- deoxycytidin MeSH
- fluoruracil MeSH
- gemcitabin MeSH
- ifosfamid MeSH
- karboplatina MeSH
- mitomycin MeSH
- paclitaxel MeSH
- paklitaxel vázaný na albumin MeSH
BACKGROUND: To investigate the impact of perioperative chemo(radio)therapy in advanced primary urethral carcinoma (PUC). PATIENTS AND METHODS: A series of 124 patients (86 men, 38 women) were diagnosed with and underwent surgery for PUC in 10 referral centers between 1993 and 2012. Kaplan-Meier analysis with log-rank testing was used to investigate the impact of perioperative chemo(radio)therapy on overall survival (OS). The median follow-up was 21 months (mean: 32 months; interquartile range: 5-48). RESULTS: Neoadjuvant chemotherapy (NAC), neoadjuvant chemoradiotherapy (N-CRT) plus adjuvant chemotherapy (ACH), and ACH was delivered in 12 (31%), 6 (15%) and 21 (54%) of these patients, respectively. Receipt of NAC/N-CRT was associated with clinically node-positive disease (cN+; P = 0.033) and lower utilization of cystectomy at surgery (P = 0.015). The objective response rate to NAC and N-CRT was 25% and 33%, respectively. The 3-year OS for patients with objective response to neoadjuvant treatment (complete/partial response) was 100% and 58.3% for those with stable or progressive disease (P = 0.30). Of the 26 patients staged ≥cT3 and/or cN+ disease, 16 (62%) received perioperative chemo(radio)therapy and 10 upfront surgery without perioperative chemotherapy (38%). The 3-year OS for this locally advanced subset of patients (≥cT3 and/or cN+) who received NAC (N = 5), N-CRT (N = 3), surgery-only (N = 10) and surgery plus ACH (N = 8) was 100%, 100%, 50% and 20%, respectively (P = 0.016). Among these 26 patients, receipt of neoadjuvant treatment was significantly associated with improved 3-year relapse-free survival (RFS) (P = 0.022) and OS (P = 0.022). Proximal tumor location correlated with inferior 3-year RFS and OS (P = 0.056/0.005). CONCLUSION: In this series, patients who received NAC/N-CRT for cT3 and/or cN+ PUC appeared to demonstrate improved survival compared with those who underwent upfront surgery with or without ACH.
2nd Medical School Department of Urology Charles University Prague Czech Republic
Department of Radiooncology Massachusetts General Hospital Harvard Medical School Boston USA
Department of Urologic Surgery Vanderbilt University Medical Center Nashville USA
Department of Urology University Hospital Bern Bern Switzerland
Department of Urology University Hospital Regensburg Regensburg Germany
Department of Urology University Medical Center Hamburg Eppendorf Hamburg
Department of Urology University of Michigan Ann Arbor USA
Department of Urology University of Tuebingen Tuebingen Germany
Institute of Urology USC Norris Comprehensive Cancer Center Los Angeles
Urology and Nephrology Center Mansoura Clinic Mansoura Egypt
Citace poskytuje Crossref.org
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