OA: Effectiveness of Adjuvant Chemotherapy After Radical Nephroureterectomy for Locally Advanced and/or Positive Regional Lymph Node UTUC Ovarian Cancer and Us OVARIAN CANCER and US Ovarian Cancer and Us

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Wednesday, January 04, 2017

OA: Effectiveness of Adjuvant Chemotherapy After Radical Nephroureterectomy for Locally Advanced and/or Positive Regional Lymph Node UTUC



Blogger's Note: genetics/hereditary links were not part of this study (eg. Lynch Syndrome)

open access:
Effectiveness of Adjuvant Chemotherapy After Radical Nephroureterectomy for Locally Advanced and/or Positive Regional Lymph Node Upper Tract Urothelial Carcinoma 
pdf version
Data Source
Established in 1989 by the American Cancer Society and the American College of Surgeons Commission on Cancer, NCDB includes all patients who were seen at one of the 1,500 participating Commission on Cancer–accredited institutions for initial diagnosis and/or first course of treatment administered. The data set captures more than 70% of incident neoplasms in the United States, comprising more than 29 million unique cancer cases. Trained data abstractors use a standardized methodology14 to collect demographic and clinical data, including tumor type, stage, grade, and treatments.

Study Population
From a population of 43,431 men and women who were diagnosed with ureter or renal pelvis tumors between 2004 and 2012........ Our final study population thus included 3,253 individuals (Fig 1).
We report an OS benefit in patients who received AC versus observation after RNU for pT3/T4 and/or pN+ UTUC. Although our results are limited by the usual biases related to the observational study design, we believe that the present findings should be considered when advising post-RNU management of advanced UTUC, pending level I evidence.

Arising from the urothelium that lines the ureter and renal pelvis, upper tract urothelial carcinomas (UTUCs) are uncommon and account for only 5% to 10% of all urothelial malignancies.1 Although kidney-sparing surgery is indicated for selected cases of low-risk disease,2 radical nephroureterectomy (RNU) with bladder cuff removal remains the standard of care for the vast majority of these tumors.3 Striving to improve the survival of individuals with adverse clinical and/or pathologic features, the role of perioperative chemotherapy as an adjunct to RNU has been explored by several observational studies over the past decade......

reference ('hereditary):
25. Hollande C, Colin P, de La Motte Rouge T,
et al: Hereditary-like urothelial carcinomas of the
upper urinary tract benefit more from adjuvant
cisplatin-based chemotherapy after radical nephroureterectomy
than do sporadic tumours. BJU Int113:574-580, 2014

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