title: The result of adjuvant chemotherapy for localized pT3 upper urinary tract carcinoma in a multi-institutional study.
abstract: OBJECTIVE
  To determine through the analysis of our multi-institutional database whether postoperative adjuvant chemotherapy for upper urinary tract carcinoma with localized invasive upper urinary tract carcinoma (UUTC) is beneficial.
  
  
  METHODS
  A study population of 93 patients with pT3N0/xM0 UUTC was eligible for this study. Clinical features evaluated were sex, tumor location, adjuvant chemotherapy status, tumor pathology (histology, grade, infiltrating growth, lymphovascular invasion (LVI)), and cause of death. Cancer-specific survival (CSS) was estimated by Kaplan-Meier method. Prognostic factors related to CSS were analyzed by Cox proportional hazards regression model for multivariate analysis.
  
  
  RESULTS
  In pT3 patients, overall 5-year CSS rate was 68.4% and median CSS time was 31 months (range 3-114 months). In the adjuvant chemotherapy group, 5-year CSS rate was 80.8%, whereas 5-year CSS rate was 64.4% in the non-adjuvant chemotherapy group. By multivariate analysis, adjuvant chemotherapy status was significantly associated with CSS (P = 0.008) were sex, tumor grade, tumor histology, and LVI presence.
  
  
  CONCLUSIONS
  This study, although it was retrospective study, revealed that adjuvant chemotherapy after RNU may be beneficial in pT3N0/X patients by multivariate analysis. Prospective studies evaluating adjuvant therapy regimens for UTTC are required.
authors: Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka 565-0871, Japan.
authors: Atsunari
authors: A
authors: Kawashima
authors: Yasutomo
authors: Y
authors: Nakai
authors: Masashi
authors: M
authors: Nakayama
authors: Takeshi
authors: T
authors: Ujike
authors: Go
authors: G
authors: Tanigawa
authors: Yutaka
authors: Y
authors: Ono
authors: Akihito
authors: A
authors: Kamoto
authors: Tsuyosi
authors: T
authors: Takada
authors: Yuichiro
authors: Y
authors: Yamaguchi
authors: Hitoshi
authors: H
authors: Takayama
authors: Kazuo
authors: K
authors: Nishimura
authors: Norio
authors: N
authors: Nonomura
authors: Akira
authors: A
authors: Tsujimura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant / Q000379:methods*; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000627:therapeutic use; D016208:Databases, Factual / Q000706:statistics & numerical data; D004317:Doxorubicin / Q000627:therapeutic use; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D008942:Mitoxantrone / Q000627:therapeutic use; D015999:Multivariate Analysis; D009392:Nephrectomy / Q000401:mortality; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D014516:Ureteral Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D014747:Vinblastine / Q000627:therapeutic use
chemical_list: D003561:Cytarabine; D014747:Vinblastine; D005047:Etoposide; D004317:Doxorubicin; D008942:Mitoxantrone; D002945:Cisplatin; D008727:Methotrexate