title: Adjuvant radiotherapy for stage III/IV urothelial carcinoma of the upper tract.
abstract: OBJECTIVE
  In order to define the role of adjuvant radiotherapy (RT), the clinical outcomes of patients with stage III/IV urothelial carcinoma of the upper urinary tract (UTUC) were reviewed.
  
  
  METHODS
  Clinical data from a total of 127 patients who underwent radical nephroureterectomy with bladder cuff were analyzed. While 36 patients underwent adjuvant RT following surgery, 91 were treated with surgery-alone. Differences in risk-adjusted treatment outcomes between the two groups were assessed using a multivariable Cox proportional-hazards model and inverse probability of treatment weighting with propensity score for balancing covariates including use of chemotherapy between the two groups was estimated.
  
  
  RESULTS
  With a median follow-up of 38.3 months, 3-year actuarial locoregional recurrence-free survival rates were 89% vs. 61% in the RT vs. non-RT groups, respectively (p=0.01). Three-year bladder recurrence-free survival rates were 73% and 52% in favor of the RT group (p=0.02). After adjustment for differences in covariates, the risks of locoregional, bladder, and disease recurrence were found significantly lower in the RT group.
  
  
  CONCLUSIONS
  Adjuvant RT may be beneficial in terms of locoregional and bladder control in patients with stage III/IV UTUC. Further prospective studied are needed to verify these findings.
authors.affiliation: M.D., Department of Radiation Oncology, Asan Medical Center, University of Ulsan, College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea. ysk@amc.seoul.kr.
authors.forename: Eunjin
authors.initials: E
authors.lastname: Jwa
authors.forename: Young Seok
authors.initials: YS
authors.lastname: Kim
authors.forename: Hanjong
authors.initials: H
authors.lastname: Ahn
authors.forename: Choung-Soo
authors.initials: CS
authors.lastname: Kim
authors.forename: Jae-Lyun
authors.initials: JL
authors.lastname: Lee
authors.forename: Seon Ok
authors.initials: SO
authors.lastname: Kim
authors.forename: Seung
authors.initials: S
authors.lastname: DO Ahn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy; D009367:Neoplasm Staging; D011379:Prognosis; D018714:Radiotherapy, Adjuvant / Q000401:mortality*; D012189:Retrospective Studies; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy
keywords: Urothelial carcinoma; adjuvant treatment; radiotherapy; upper urinary tract