title: Comparison of Efficacy of Adjuvant MEC (Methotrexate, Epirubicin and Cisplatin) and GC (Gemcitabine and Cisplatin) in Advanced Upper Tract Urothelial Carcinoma.
abstract: To evaluate the efficacy of methotrexate, epirubicin and cisplatin (MEC) or gemcitabine and cisplatin (GC) as adjuvant chemotherapy in advanced upper tract urothelium carcinoma (UTUC).
  
  
  
  From 2002 January to 2008 December, a total of 70 patients with advanced UTUC received radical nephroureterctomy at our Institute with MEC and GC as adjuvant chemotherapy. Disease-free survival (DFS), cancer-specific survival (CSS) and overall survival (OS) among the two groups were evaluated.
  
  
  
  The MEC (n=30) and GC group (n=40) were compared and showed no significant differences in DFS (p=0.859), CSS (p=0.722) and OS (p=0.691). Positive lymph nodes, preoperative creatinine >1.5, old age, a high ECOG state and low BMI are all the independent risk factors of poor prognosis in advanced UTUC.
  
  
  
  In patients with UTUC, MEC has a non-inferior efficacy to GC in consideration of cancer recurrence, cancer-specific survival and overall survival.
authors.affiliation: Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
authors.forename: Sheng-Chun
authors.initials: SC
authors.lastname: Hung
authors.affiliation: Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.|School of Medicine, Chung Shan Medical University, Taichung, Taiwan, R.O.C.|Department of Applied Chemistry, National Chi Nan University, Puli, Taiwan, R.O.C.
authors.forename: Shian-Shiang
authors.initials: SS
authors.lastname: Wang
authors.affiliation: Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
authors.forename: Chun-Kuang
authors.initials: CK
authors.lastname: Yang
authors.affiliation: Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
authors.forename: Jian-Ri
authors.initials: JR
authors.lastname: Li
authors.affiliation: Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
authors.forename: Chen-Li
authors.initials: CL
authors.lastname: Cheng
authors.affiliation: Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
authors.forename: Yen-Chuan
authors.initials: YC
authors.lastname: Ou
authors.affiliation: Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
authors.forename: Hao-Chung
authors.initials: HC
authors.lastname: Ho
authors.affiliation: Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
authors.forename: Kun-Yuan
authors.initials: KY
authors.lastname: Chiu
authors.affiliation: Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C. r2060d@yahoo.com.tw.
authors.forename: Chuan-Shu
authors.initials: CS
authors.lastname: Chen
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy* / Q000556:secondary; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014571:Urologic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D015251:Epirubicin; D002945:Cisplatin; D008727:Methotrexate; D000093542:Gemcitabine