scholarly journals Effect of preoperative chemotherapy on survival of patients with upper urinary tract urothelial carcinoma clinically involving regional lymph nodes

2015 ◽  
Vol 23 (2) ◽  
pp. 153-158 ◽  
Author(s):  
Kazuhiro Kobayashi ◽  
Toshihiro Saito ◽  
Yasuo Kitamura ◽  
Vladimir Bilim ◽  
Tomotaka Toba ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Lymph Nodes ◽  
Urothelial Carcinoma ◽  
Preoperative Chemotherapy ◽  
Upper Urinary Tract ◽  
Regional Lymph Nodes ◽  
Urinary Tract Urothelial Carcinoma

scholarly journals Effect of lymph node dissection on stage-specific survival in patients with upper urinary tract urothelial carcinoma treated with nephroureterectomy

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ting-Shuai Zhai ◽  
Liang Jin ◽  
Zhen Zhou ◽  
Xiang Liu ◽  
Huan Liu ◽  
...  
Keyword(s):  
Lymph Node ◽  
Urinary Tract ◽  
Lymph Nodes ◽  
Urothelial Carcinoma ◽  
Cox Regression ◽  
Upper Urinary Tract ◽  
Regression Analyses ◽  
Node Dissection ◽  
Regional Lymph Nodes ◽  
Urinary Tract Urothelial Carcinoma

Abstract Background We aimed to estimate the stage-specific impact of lymph node dissection (LND) on survival for upper urinary tract urothelial carcinoma (UTUC) patients treated with nephroureterectomy (NU). Methods Overall, 7278 UTUC patients undergoing NU within the SEER database from 2004 to 2015 were identified. Kaplan-Meier plots illustrated overall survival (OS) and cancer-specific survival (CSS) rates according to LND status. Multivariable Cox regression analyses assessed the effect of LND on OS and CSS rates stratified by pathological tumor stage. Results LND was performed in 26.9% of patients, and in 18.6, 23.3, 31.2 and 45.9% for pT1, pT2, pT3 and pT4 patients, respectively (P <  0.001). In multivariable Cox regression analyses, LND was associated with a higher OS or CSS in UTUC patients with pT3 and pT4 disease (all P <  0.05), but failed to achieve independent predictor status in patients with pT1 and pT2 disease (all P > 0.05). LND with 1 to 3 regional lymph nodes removed was prone to a higher OS or CSS only in pT4 compared to no LND (both P <  0.01). LND with 4 or more regional lymph nodes removed predisposed to a higher OS or CSS in pT3 or pT4 (all P <  0.05). Conclusions The beneficial effect of LND especially LND with 4 or more regional lymph nodes removed on survival was evident in pT3/4 patients. LND can be considered for pT3 and pT4, for pT1/2 remains to be seen, both of which will be verified by further prospective studies.

scholarly journals Effect of lymph node dissection on stage-specific survival in patients with upper urinary tract urothelial carcinoma treated with nephroureterectomy

2019 ◽  
Author(s):  
Ting-Shuai Zhai ◽  
Liang Jin ◽  
Zhen Zhou ◽  
Xiang Liu ◽  
Huan Liu ◽  
...  
Keyword(s):  
Lymph Node ◽  
Urinary Tract ◽  
Lymph Nodes ◽  
Urothelial Carcinoma ◽  
Cox Regression ◽  
Upper Urinary Tract ◽  
Regression Analyses ◽  
Node Dissection ◽  
Regional Lymph Nodes ◽  
Urinary Tract Urothelial Carcinoma

Abstract Objectives To estimate the stage-specific impact of lymph node dissection (LND) on survival for upper urinary tract urothelial carcinoma (UTUC) patients treated with nephroureterectomy (NU). Methods Overall, 7278 UTUC patients undergoing NU within the SEER database from 2004 to 2015 were identified. Kaplan-Meier plots illustrated overall survival (OS) and cancer-specific survival (CSS) rates according to LND status. Multivariable Cox regression analyses assessed the effect of LND on OS and CSS rates stratified by pathological tumor stage. Results LND was performed in 26.9% of patients, and in 18.6, 23.3, 31.2 and 45.9% for pT1, pT2, pT3 and pT4 patients, respectively (P < 0.001). In multivariable Cox regression analyses, LND was associated with a higher OS or CSS in UTUC patients with pT3 and pT4 disease (all P < 0.05), but failed to achieve independent predictor status in patients with pT1 and pT2 disease (all P > 0.05). LND with 1 to 3 regional lymph nodes removed was prone to a higher OS or CSS only in pT4 compared to no LND (both P < 0.01). LND with 4 or more regional lymph nodes removed predisposed to a higher OS or CSS in pT3 or pT4 (all P < 0.05). Conclusion The beneficial effect of LND especially LND with 4 or more regional lymph nodes removed on survival was evident in pT3/4 patients. LND can be considered for pT3 and pT4, for pT1/2 remains to be seen, both of which will be verified by further prospective studies.

scholarly journals Effect of lymph node dissection on stage-specific survival in patients with upper urinary tract urothelial carcinoma treated with nephroureterectomy

2019 ◽  
Author(s):  
Ting-Shuai Zhai ◽  
Liang Jin ◽  
Zhen Zhou ◽  
Xiang Liu ◽  
Huan Liu ◽  
...  
Keyword(s):  
Lymph Node ◽  
Urinary Tract ◽  
Lymph Nodes ◽  
Urothelial Carcinoma ◽  
Cox Regression ◽  
Upper Urinary Tract ◽  
Regression Analyses ◽  
Node Dissection ◽  
Regional Lymph Nodes ◽  
Urinary Tract Urothelial Carcinoma

Abstract Objectives To estimate the stage-specific impact of lymph node dissection (LND) on survival for upper urinary tract urothelial carcinoma (UTUC) patients treated with nephroureterectomy (NU). Methods Overall, 7278 UTUC patients undergoing NU within the SEER database from 2004 to 2015 were identified. Kaplan-Meier plots illustrated overall survival (OS) and cancer-specific survival (CSS) rates according to LND status. Multivariable Cox regression analyses assessed the effect of LND on OS and CSS rates stratified by pathological tumor stage. Results LND was performed in 26.9% of patients, and in 18.6, 23.3, 31.2 and 45.9% for pT1, pT2, pT3 and pT4 patients, respectively (P < 0.001). In multivariable Cox regression analyses, LND was associated with a higher OS or CSS in UTUC patients with pT3 and pT4 disease (all P < 0.05), but failed to achieve independent predictor status in patients with pT1 and pT2 disease (all P > 0.05). LND with 1 to 3 regional lymph nodes removed was prone to a higher OS or CSS only in pT4 compared to no LND (both P < 0.01). LND with 4 or more regional lymph nodes removed predisposed to a higher OS or CSS in pT3 or pT4 (all P < 0.05). Conclusion The beneficial effect of LND especially LND with 4 or more regional lymph nodes removed on survival was evident in pT3/4 patients. LND can be considered for pT3 and pT4, for pT1/2 remains to be seen, both of which will be verified by further prospective studies.

scholarly journals Effect of lymph node dissection on stage-specific survival in patients with upper urinary tract urothelial carcinoma treated with nephroureterectomy.

2019 ◽  
Author(s):  
Ting-Shuai Zhai ◽  
Liang Jin ◽  
Zhen Zhou ◽  
Xiang Liu ◽  
Huan Liu ◽  
...  
Keyword(s):  
Lymph Node ◽  
Urinary Tract ◽  
Lymph Nodes ◽  
Cox Regression ◽  
Tumor Stage ◽  
Upper Urinary Tract ◽  
Regression Analyses ◽  
Node Dissection ◽  
Regional Lymph Nodes ◽  
Urinary Tract Urothelial Carcinoma

Abstract Objectives To estimate the stage-specific impact of lymph node dissection (LND) on survival for upper urinary tract urothelial carcinoma (UTUC) patients treated with nephroureterectomy (NU). Methods Overall, 7278 UTUC patients undergoing NU within the SEER database from 2004 to 2015 were identified. Kaplan-Meier plots illustrated overall survival (OS) and cancer-specific survival (CSS) rates according to LND status. Multivariable Cox regression analyses assessed the effect of LND on OS and CSS rates stratified by pathological tumor stage. Results LND was performed in 26.9% of patients, and in 18.6, 23.3, 31.2 and 45.9% for pT1, pT2, pT3 and pT4 patients, respectively (P < 0.001). In multivariable Cox regression analyses, LND was associated with a higher OS or CSS in UTUC patients with pT3 and pT4 disease (all P < 0.05), but failed to achieve independent predictor status in patients with pT1 and pT2 disease (all P > 0.05). LND with 1 to 3 regional lymph nodes removed was prone to a higher OS or CSS only in pT4 compared to no LND (both P < 0.01). LND with 4 or more regional lymph nodes removed predisposed to a higher OS or CSS in pT3 or pT4 (all P < 0.05). Conclusion LND was more frequently performed in locally advanced UTUC patients. The beneficial effect of LND especially LND with 4 or more regional lymph nodes removed on survival was more significant in these patients than those with pT1 or pT2 disease. LND at UN should always be contemplated, regardless of tumor stage.

scholarly journals Comparison of oncologic and functional outcomes between radical nephroureterectomy and segmental ureterectomy for upper urinary tract urothelial carcinoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tae Heon Kim ◽  
Chung Un Lee ◽  
Minyong Kang ◽  
Hwang Gyun Jeon ◽  
Byong Chang Jeong ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urothelial Carcinoma ◽  
Functional Outcomes ◽  
Upper Urinary Tract ◽  
Rank Test ◽  
Radical Nephroureterectomy ◽  
Free Survival ◽  
Significant Difference ◽  
Segmental Ureterectomy ◽  
Urinary Tract Urothelial Carcinoma

AbstractThis study aims to compare oncologic and functional outcomes after radical nephroureterectomy (RNU) and segmental ureterectomy (SU) in patients with upper urinary tract urothelial carcinoma (UTUC). We retrospectively collected data on patients who underwent either RNU or SU of UTUC. Propensity score matching was performed among 394 cases to yield a final cohort of 40 RNU and 40 SU cases. Kaplan–Meier analysis and the log-rank test were used to compare overall survival (OS), cancer-specific survival (CSS), progression-free survival (PFS), and intravesical recurrence-free survival (IVRFS) between the groups. We also compared the change in postoperative estimated glomerular filtration rate (eGFR). There was no significant difference in terms of CSS, PFS, and IVRFS between the RNU and SU groups, but the RNU group had a better OS than the SU group (p = 0.032). Postoperative eGFR was better preserved in the SU group than in the RNU group (p < 0.001). SU provides comparable CSS, PFS, and IVRFS for patients with UTUC compared to RNU, even in patients with advanced-stage and/or high-grade cancer. Further, SU achieves better preservation of renal function.

scholarly journals Combination of pembrolizumab and BCG treatment after endoscopic ablation of high-risk superficial upper urinary tract urothelial carcinoma in patients not candidates for radical nephroureterectomy: protocol for phase-II study

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e027066
Author(s):  
Marcus L Jamil ◽  
Mustafa Deebajah ◽  
Akshay Sood ◽  
Shaheen Alanee
Keyword(s):  
Urinary Tract ◽  
High Risk ◽  
Urothelial Carcinoma ◽  
Phase Ii ◽  
Upper Urinary Tract ◽  
Fixed Dose ◽  
Radical Nephroureterectomy ◽  
Safety And Efficacy ◽  
Muscle Invasive ◽  
Urinary Tract Urothelial Carcinoma

IntroductionThe treatment standard for high-risk upper urinary tract urothelial carcinoma (UUTUC) is radical nephroureterectomy. However, some patients may be unfit or unwilling, and in such patients the available alternatives are suboptimal. Therapies targeting the programmed death (PD) pathway have shown promise in urothelial carcinom (UC). We designed the current study to determine the safety and efficacy of administering MK-3475 (a monoclonal antibody targeting interaction between PD-1 and its ligand) in combination with bacillus Calmette-Guerin (BCG) in high-risk non-muscle invasive UUTUC patients.MethodsThis represents a single-centre phase-II efficacy study of MK-3475 therapy in combination with BCG for subjects, 18 years of age or older, with pathologically documented non-muscle invasive high-risk UUTUC unfit or unwilling to be treated with radical nephroureterectomy. Twenty subjects will be enrolled; patients will receive treatment with 200 mg of MK-3475 every 21 days, starting 2 weeks from the initial endoscopic resection and continuing for 6 weeks after the final dose of BCG. The primary objective is to determine the safety and efficacy of administering MK-3475 at a fixed dose of 200 mg every 3 weeks in conjunction with intrapelvic BCG. Secondary objectives include 19 week and the 3, 12 and 24-month post-treatment completion complete response and progression-free rate assessments.Ethics and disseminationThe study has been approved by the Institutional Review Board of the Henry Ford Hospital. The results of this study will be published in a peer-reviewed journal and presented at a scientific conference.Trial registration numberNCT03345134

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