Hereditary-like urothelial carcinomas of the upper urinary tract benefit more from adjuvant cisplatin-based chemotherapy after radical nephroureterectomy than do sporadic tumours.
OBJECTIVE
To evaluate the impact of 'hereditary-like' status in upper tract urothelial carcinoma (UTUC) on the survival of patients who have undergone radical nephroureterectomy (RNU) and adjuvant chemotherapy.


METHODS
A multicentre retrospective study was performed on all patients with high-risk UTUC who underwent RNU and adjuvant cisplatin-based chemotherapy. Using a patient risk identification tool, we distinguished tumours suspected to be hereditary from sporadic tumours and compared survival rates.


RESULTS
A total of 112 patients with a median age of 67 years were included. Hereditary-like tumour status was detected in 35 patients (31.3%), while 77 patients (68.7%) had sporadic tumours. The median age was significantly younger in the hereditary-like tumour group (56.0 vs 69.8 years, P < 0.001). Overall survival (OS) after chemotherapy was significantly better in the group with hereditary-like tumours than in the group with sporadic tumours (5-year OS: 48.2 vs 32%; P = 0.008). The cancer-specific survival (CSS) rate was significantly better in the group with 'hereditary-like' tumours than in the group with sporadic tumours (5-year CSS: 58 vs 35%; P = 0.006). Although there was a trend in favour of the hereditary-like tumours, we observed no significant difference regarding progression-free survival (PFS) between the two groups (5-year PFS: 71 vs 52%; P = 0.07).


CONCLUSIONS
Adjuvant chemotherapy after RNU improves survival outcomes in patients with hereditary-like UTUC compared with those with sporadic tumours.
Academic Department of Oncology, University Paris VI, Paris, France.
Clémence
C
Hollande
Pierre
P
Colin
Thibault
T
de La Motte Rouge
François
F
Audenet
David R
DR
Yates
Véronique
V
Phé
Adil
A
Ouzzane
Stéphane
S
Droupy
Alain
A
Ruffion
Alexandre
A
de La Taille
Laurent
L
Guy
Olivier
O
Cussenot
François
F
Rozet
Evanguelos
E
Xylinas
Marc
M
Zerbib
Jean-Philippe
JP
Spano
David
D
Khayat
Marc-Olivier
MO
Bitker
Morgan
M
Rouprêt
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000235:genetics / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*; D014516:Ureteral Neoplasms / Q000188:drug therapy / Q000235:genetics / Q000601:surgery*
D000970:Antineoplastic Agents; D002945:Cisplatin
HNPCC; chemotherapy; renal pelvis; ureter; urothelial carcinoma