title: Diversity in treatment modalities of Stage II/III urothelial cancer in Japan: sub-analysis of the multi-institutional national database of the Japanese Urological Association.
abstract: OBJECTIVE
  We aimed to survey treatment modalities for the patients with Stage II/III urothelial cancer in Japan.
  
  
  METHODS
  We used the multi-institutional national database of the Japanese Urological Association from 348 Japanese institutions, in which a total of 3707 patients with muscle-invasive bladder cancer and 1538 with upper urinary tract urothelial carcinoma were registered in 2008 and 2011, respectively. Primary treatment was classified as surgery alone, surgery with chemotherapy, surgery with radiation, radiation alone, chemotherapy alone, combination of radiation and chemotherapy and observation. Overall and cancer-specific survivals were examined using the Kaplan-Meier method, and survival in the subgroups was analyzed using the log-rank test.
  
  
  RESULTS
  In Stage II/III bladder cancer patients, 49.7% of those were treated with radical operation and 22.3% received observation only. A total 97.2% of Stage II/III upper urinary tract urothelial carcinoma patients treated with radical surgery. A total 30.4% of Stage II/III bladder cancer patients received chemotherapy. Majority of the patients received cisplatin-based regimen, however, regimens of chemotherapy was rich in variety up to 13 regimens. Chemotherapy regimens for the patients with upper urinary tract urothelial carcinoma were also various up to eight regimens. Overall and cancer-specific survivals were statistically significantly stratified according to the clinical stage. The upper urinary tract urothelial carcinoma patients diagnosed with clinical stage T3 had significantly poor prognosis compared with those diagnosed with clinical stage T2.
  
  
  CONCLUSIONS
  This study demonstrated the variety of treatments used for Japanese patients with Stage II/III urothelial cancer. Treatment standardization for these entities may be necessary.
authors: Working Group of the Upper Urinary Tract Urothelial Carcinoma (UTUC) Registration Committee of the Japanese Urological Association Department of Urology, Hirosaki University Graduate School of Medicine, Aomori.
authors: Takuya
authors: T
authors: Koie
authors: Working Group of the Upper Urinary Tract Urothelial Carcinoma (UTUC) Registration Committee of the Japanese Urological Association Department of Urology, Hirosaki University Graduate School of Medicine, Aomori coyama@hirosaki-u.ac.jp.
authors: Chikara
authors: C
authors: Ohyama
authors: Working Group of the Upper Urinary Tract Urothelial Carcinoma (UTUC) Registration Committee of the Japanese Urological Association Urology Division, National Cancer Center Hospital, Tokyo.
authors: Hiroyuki
authors: H
authors: Fujimoto
authors: Working Group of the Upper Urinary Tract Urothelial Carcinoma (UTUC) Registration Committee of the Japanese Urological Association Department of Urology, Faculty of Medicine, University of Tsukuba, Ibaraki.
authors: Hiroyuki
authors: H
authors: Nishiyama
authors: Working Group of the Upper Urinary Tract Urothelial Carcinoma (UTUC) Registration Committee of the Japanese Urological Association Department of Urology, Faculty of Medicine, University of Tsukuba, Ibaraki.
authors: Jun
authors: J
authors: Miyazaki
authors: Working Group of the Upper Urinary Tract Urothelial Carcinoma (UTUC) Registration Committee of the Japanese Urological Association Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama.
authors: Shiro
authors: S
authors: Hinotsu
authors: Working Group of the Upper Urinary Tract Urothelial Carcinoma (UTUC) Registration Committee of the Japanese Urological Association Department of Urology, Keio University School of Medicine, Tokyo.
authors: Eiji
authors: E
authors: Kikuchi
authors: Working Group of the Upper Urinary Tract Urothelial Carcinoma (UTUC) Registration Committee of the Japanese Urological Association Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, Tokyo.
authors: Mizuaki
authors: M
authors: Sakura
authors: Working Group of the Upper Urinary Tract Urothelial Carcinoma (UTUC) Registration Committee of the Japanese Urological Association Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors: Junichi
authors: J
authors: Inokuchi
authors: Working Group of the Upper Urinary Tract Urothelial Carcinoma (UTUC) Registration Committee of the Japanese Urological Association Urology Division, National Cancer Center Hospital, Tokyo.
authors: Tomohiko
authors: T
authors: Hara
authors: Chikara
authors: C
authors: Ohyama
authors: Hiroyuki
authors: H
authors: Nishiyama
authors: Masato
authors: M
authors: Fujisawa
authors: Hirotsugu
authors: H
authors: Uemura
authors: Hiroyuki
authors: H
authors: Fujimoto
authors: Kazuhiro
authors: K
authors: Suzuki
authors: Masatoshi
authors: M
authors: Eto
authors: Isao
authors: I
authors: Hara
authors: Akio
authors: A
authors: Matsubara
authors: Norio
authors: N
authors: Nonomura
authors: Hiroyuki
authors: H
authors: Nakanishi
authors: Takuya
authors: T
authors: Koie
authors: Hiroomi
authors: H
authors: Kanayama
authors: Tsuneharu
authors: T
authors: Miki
authors: Tomoharu
authors: T
authors: Fukumori
authors: Seiji
authors: S
authors: Naito
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012042:Registries; D012189:Retrospective Studies; D016019:Survival Analysis; D014571:Urologic Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*
chemical_list: D000970:Antineoplastic Agents
keywords: Japanese patients; muscle-invasive bladder cancer; survival; treatment modality; upper urinary tract urothelial carcinoma