title: Effect of Adjuvant Radiotherapy on Survival in Patients with Locoregional Urothelial Malignancies of the Upper Urinary Tract.
abstract: BACKGROUND
  While radical nephroureterectomy is the treatment of choice for localized or regional urothelial carcinoma of the upper urinary tract (UTUC), the role of adjuvant radiotherapy is unclear, with conflicting data from various small studies.
  
  
  METHODS
  We sought to study the impact of adjuvant radiotherapy on UTUC by utilizing the Survelliance, Epidemiolgy, and End Results (SEER) 9 database from 1998-2011.
  
  
  RESULTS
  Of 2,572 identified cases, 113 patients (4.4%) received adjuvant radiotherapy, with a median age of 74 years (range=22-100 years). In univariate analysis, patients treated with adjuvant radiation therapy seemed to have a lower survival time than those without radiation therapy (19 months versus 31 months, p<0.05). However, after adjusting for covariates, including age at diagnosis, gender, race, year of diagnosis, stage, histological grade and surgery, radiation therapy did not seem to influence survival (hazard ratio=0.68; 95% confidence interval=0.68-1.06, p=0.85).
  
  
  CONCLUSIONS
  This hypothesis-generating, population-based analysis shows that adjuvant radiotherapy may not influence survival among patients with locoregional UTUC.
authors.affiliation: Department of Internal Medicine, University of Utah, Salt Lake City, UT, U.S.A. ahahn100@gmail.com.
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Hahn
authors.affiliation: Department of Internal Medicine, University of Tennessee Health Science Center, Memphis, TN, U.S.A.
authors.forename: Smith
authors.initials: S
authors.lastname: Giri
authors.affiliation: Department of Internal Medicine, Reading Health System, Reading, PA, U.S.A.
authors.forename: Ranjan
authors.initials: R
authors.lastname: Pathak
authors.affiliation: Department of Hematology/Oncology, University of Nebraska Medical Center, Omaha, NE, U.S.A.
authors.forename: Vijaya Raj
authors.initials: VR
authors.lastname: Bhatt
authors.affiliation: Department of Internal Medicine, University of Tennessee Health Science Center, Memphis, TN, U.S.A. Department of Hematology/Oncology, The West Cancer Center, Memphis, TN, U.S.A.
authors.forename: Mike G
authors.initials: MG
authors.lastname: Martin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000473:pathology / Q000532:radiotherapy*; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects / Q000379:methods*; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000532:radiotherapy*; D019459:Urothelium / Q000473:pathology* / Q000528:radiation effects
keywords: Radiotherapy; upper urinary tract; urothelial carcinoma