Gemcitabine–cisplatin versus MVAC chemotherapy for urothelial carcinoma: a nationwide cohort study
Abstract This study assessed the trends in methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) and gemcitabine–cisplatin (GC) regimens in Korean patients with metastatic urothelial carcinoma (UC) and compared the side effects and overall survival (OS) rates of the two regimens using nationw...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-03-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-30356-x |
| _version_ | 1797864749721976832 |
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| author | Yong Seong Lee Moon Soo Ha Jong Hyun Tae In Ho Chang Tae-Hyoung Kim Soon Chul Myung Tuan Thanh Nguyen Myoungsuk Kim Kyung-Eun Lee Yuwon Kim Hyun-ki Woo Dae-Sung Kyoung Hasung Kim Se Young Choi |
| author_facet | Yong Seong Lee Moon Soo Ha Jong Hyun Tae In Ho Chang Tae-Hyoung Kim Soon Chul Myung Tuan Thanh Nguyen Myoungsuk Kim Kyung-Eun Lee Yuwon Kim Hyun-ki Woo Dae-Sung Kyoung Hasung Kim Se Young Choi |
| author_sort | Yong Seong Lee |
| collection | DOAJ |
| description | Abstract This study assessed the trends in methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) and gemcitabine–cisplatin (GC) regimens in Korean patients with metastatic urothelial carcinoma (UC) and compared the side effects and overall survival (OS) rates of the two regimens using nationwide population-based data. The data of patients diagnosed with UC between 2004 and 2016 were collected using the National Health Insurance Service database. The overall treatment trends were assessed according to the chemotherapy regimens. The MVAC and GC groups were matched by propensity scores. Cox proportional hazard analysis and Kaplan–Meier analysis were performed to assess survival. Of 3108 patients with UC, 2,880 patients were treated with GC and 228 (7.3%) were treated with MVAC. The transfusion rate and volume were similar in both the groups, but the granulocyte colony-stimulating factor (G-CSF) usage rate and number were higher in the MVAC group than in the GC group. Both groups had similar OS. Multivariate analysis revealed that the chemotherapy regimen was not a significant factor for OS. Subgroup analysis revealed that a period of ≥ 3 months from diagnosis to systemic therapy enhanced the prognostic effects of the GC regimen. The GC regimen was widely used as the first-line chemotherapy in more than 90% of our study population with metastatic UC. The MVAC regimen showed similar OS to the GC regimen but needed greater use of G-CSF. The GC regimen could be a suitable treatment option for metastatic UC after ≥ 3 months from diagnosis. |
| first_indexed | 2024-04-09T22:57:11Z |
| format | Article |
| id | doaj.art-5319d6edbb71431e8c646d381c47c369 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-09T22:57:11Z |
| publishDate | 2023-03-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-5319d6edbb71431e8c646d381c47c3692023-03-22T11:10:10ZengNature PortfolioScientific Reports2045-23222023-03-011311910.1038/s41598-023-30356-xGemcitabine–cisplatin versus MVAC chemotherapy for urothelial carcinoma: a nationwide cohort studyYong Seong Lee0Moon Soo Ha1Jong Hyun Tae2In Ho Chang3Tae-Hyoung Kim4Soon Chul Myung5Tuan Thanh Nguyen6Myoungsuk Kim7Kyung-Eun Lee8Yuwon Kim9Hyun-ki Woo10Dae-Sung Kyoung11Hasung Kim12Se Young Choi13Department of Urology, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of MedicineDepartment of Urology, Hyundae General Hospital, Chung-Ang University College of MedicineDepartment of Urology, Chung-Ang University Hospital, Chung-Ang University College of MedicineDepartment of Urology, Chung-Ang University Hospital, Chung-Ang University College of MedicineDepartment of Urology, Chung-Ang University Hospital, Chung-Ang University College of MedicineDepartment of Urology, Chung-Ang University Hospital, Chung-Ang University College of MedicineDepartment of Urology, Cho Ray Hospital, University of Medicine and Pharmacy at Ho Chi Minh CityData Science Team, Evidnet. Co., LtdData Science Team, Evidnet. Co., LtdData Science Team, Evidnet. Co., LtdData Science Team, Evidnet. Co., LtdData Science Team, Hanmi Pharm. Co., LtdData Science Team, Hanmi Pharm. Co., LtdDepartment of Urology, Chung-Ang University Hospital, Chung-Ang University College of MedicineAbstract This study assessed the trends in methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) and gemcitabine–cisplatin (GC) regimens in Korean patients with metastatic urothelial carcinoma (UC) and compared the side effects and overall survival (OS) rates of the two regimens using nationwide population-based data. The data of patients diagnosed with UC between 2004 and 2016 were collected using the National Health Insurance Service database. The overall treatment trends were assessed according to the chemotherapy regimens. The MVAC and GC groups were matched by propensity scores. Cox proportional hazard analysis and Kaplan–Meier analysis were performed to assess survival. Of 3108 patients with UC, 2,880 patients were treated with GC and 228 (7.3%) were treated with MVAC. The transfusion rate and volume were similar in both the groups, but the granulocyte colony-stimulating factor (G-CSF) usage rate and number were higher in the MVAC group than in the GC group. Both groups had similar OS. Multivariate analysis revealed that the chemotherapy regimen was not a significant factor for OS. Subgroup analysis revealed that a period of ≥ 3 months from diagnosis to systemic therapy enhanced the prognostic effects of the GC regimen. The GC regimen was widely used as the first-line chemotherapy in more than 90% of our study population with metastatic UC. The MVAC regimen showed similar OS to the GC regimen but needed greater use of G-CSF. The GC regimen could be a suitable treatment option for metastatic UC after ≥ 3 months from diagnosis.https://doi.org/10.1038/s41598-023-30356-x |
| spellingShingle | Yong Seong Lee Moon Soo Ha Jong Hyun Tae In Ho Chang Tae-Hyoung Kim Soon Chul Myung Tuan Thanh Nguyen Myoungsuk Kim Kyung-Eun Lee Yuwon Kim Hyun-ki Woo Dae-Sung Kyoung Hasung Kim Se Young Choi Gemcitabine–cisplatin versus MVAC chemotherapy for urothelial carcinoma: a nationwide cohort study Scientific Reports |
| title | Gemcitabine–cisplatin versus MVAC chemotherapy for urothelial carcinoma: a nationwide cohort study |
| title_full | Gemcitabine–cisplatin versus MVAC chemotherapy for urothelial carcinoma: a nationwide cohort study |
| title_fullStr | Gemcitabine–cisplatin versus MVAC chemotherapy for urothelial carcinoma: a nationwide cohort study |
| title_full_unstemmed | Gemcitabine–cisplatin versus MVAC chemotherapy for urothelial carcinoma: a nationwide cohort study |
| title_short | Gemcitabine–cisplatin versus MVAC chemotherapy for urothelial carcinoma: a nationwide cohort study |
| title_sort | gemcitabine cisplatin versus mvac chemotherapy for urothelial carcinoma a nationwide cohort study |
| url | https://doi.org/10.1038/s41598-023-30356-x |
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