Adjuvant chemotherapy in the management of pT3N0M0 transitional cell carcinoma of the upper urinary tract.
BACKGROUND
We investigate the efficacy of postoperative adjuvant chemotherapy for locally advanced, but lymph node negative, pathologic stage T3 transitional cell carcinoma (TCC) of the upper urinary tract.


METHODS
A retrospective study on 27 patients who had undergone radical nephroureterectomy with regional lymphadenectomy for pT3N0M0 primary upper urinary tract TCC at our institution from 1996 to 2001 was performed. Among the 27 patients, 16 also received adjuvant chemotherapy following surgery (adjuvant group), whereas the other 11 patients did not (nonadjuvant group).


RESULTS
Adjuvant and nonadjuvant therapy groups were not significantly different with respect to age, sex, performance status, tumor grade, and tumor location. Overall, 5 of the 16 patients (31%) in the adjuvant group and 4 of the 11 patients (36%) in the nonadjuvant group had recurrence of cancer at 40 months of follow-up. The two groups demonstrated no significant differences in recurrence-free survival (p = 0.794) and disease-specific survival (p = 0.783).


CONCLUSIONS
Although it would be difficult to draw any definite conclusions from the results of our investigations, our data suggest that adjuvant therapy with traditional conventional chemotherapeutic regimens alone may not be effective as previously anticipated in significantly improving survival rates for locally advanced, but lymph node negative, TCC of the upper urinary tract.
Lee
Sang Eun
SE
Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
Byun
Seok-Soo
SS
Park
Yong Hyun
YH
Chang
In Ho
IH
Kim
Yong June
YJ
Hong
Sung Kyu
SK
D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy* / Q000473:pathology*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D007682:Kidney Pelvis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D014516:Ureteral Neoplasms / Q000188:drug therapy* / Q000473:pathology*