Neoadjuvant versus adjuvant chemotherapy in upper tract urothelial carcinoma: A nationwide cohort study
Abstract Purpose This study aimed to evaluate the trend of adjuvant chemotherapy (AC) and neoadjuvant chemotherapy (NAC) in patients who underwent radical nephroureterectomy with bladder cuff excision (NUx) for upper tract urothelial carcinoma (UTUC) to compare the perioperative outcomes and overall...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-11-01
|
| Series: | BMC Urology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12894-022-01112-6 |
| _version_ | 1811230397586997248 |
|---|---|
| author | Jong Hyun Tae Moon Soo Ha Byung Hoon Chi 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 | Jong Hyun Tae Moon Soo Ha Byung Hoon Chi 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 | Jong Hyun Tae |
| collection | DOAJ |
| description | Abstract Purpose This study aimed to evaluate the trend of adjuvant chemotherapy (AC) and neoadjuvant chemotherapy (NAC) in patients who underwent radical nephroureterectomy with bladder cuff excision (NUx) for upper tract urothelial carcinoma (UTUC) to compare the perioperative outcomes and overall survival (OS) between AC and NAC using nationwide population-based data. Materials and methods We collected data on patients diagnosed with UTUC and treated with NUx between 2004 and 2016 using the National Health Insurance Service database, and evaluated the overall treatment trends. The AC and NAC groups were propensity score-matched. Cox proportional hazard and Kaplan-Meier analyses were used to assess survival. Results Of the 8,705 enrolled patients, 6,627 underwent NUx only, 94 underwent NAC, and 1,984 underwent AC. The rate of NUx without perioperative chemotherapy increased from 70.8 to 78.2% (R2 = 0.632; p < 0.001). The rates of dialysis (p = 0.398), TUR-BT (p = 1.000), and radiotherapy (p = 0.497) after NUx were similar. In the Kaplan-Meier curve, the NAC and AC groups showed no significant difference (p = 0.480). In multivariate analysis, treatment with AC or NAC was not associated with OS (hazard ratio 0.83, 95% confidence interval 0.49–1.40, p = 0.477). Conclusion The use of NUx without perioperative chemotherapy has tended to increase in South Korea. Dialysis, TUR-BT, and radiotherapy rates after NUx were similar between the NAC and AC groups. There was no significant difference in OS between the NAC and AC groups. Proper perioperative chemotherapy according to patient and tumor conditions should be determined by obtaining more evidence of UTUC. |
| first_indexed | 2024-04-12T10:28:45Z |
| format | Article |
| id | doaj.art-f052629fbe044e1395017e3f28f94e7f |
| institution | Directory Open Access Journal |
| issn | 1471-2490 |
| language | English |
| last_indexed | 2024-04-12T10:28:45Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Urology |
| spelling | doaj.art-f052629fbe044e1395017e3f28f94e7f2022-12-22T03:36:55ZengBMCBMC Urology1471-24902022-11-0122111010.1186/s12894-022-01112-6Neoadjuvant versus adjuvant chemotherapy in upper tract urothelial carcinoma: A nationwide cohort studyJong Hyun Tae0Moon Soo Ha1Byung Hoon Chi2In Ho Chang3Tae-Hyoung Kim4Soon Chul Myung5Tuan Thanh Nguyen6Myoungsuk Kim7Kyung-Eun Lee8Yuwon Kim9Hyun-ki Woo10Dae-Sung Kyoung11Hasung Kim12Se Young Choi13Department of Urology, Chung-Ang University 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 ChiData 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 Purpose This study aimed to evaluate the trend of adjuvant chemotherapy (AC) and neoadjuvant chemotherapy (NAC) in patients who underwent radical nephroureterectomy with bladder cuff excision (NUx) for upper tract urothelial carcinoma (UTUC) to compare the perioperative outcomes and overall survival (OS) between AC and NAC using nationwide population-based data. Materials and methods We collected data on patients diagnosed with UTUC and treated with NUx between 2004 and 2016 using the National Health Insurance Service database, and evaluated the overall treatment trends. The AC and NAC groups were propensity score-matched. Cox proportional hazard and Kaplan-Meier analyses were used to assess survival. Results Of the 8,705 enrolled patients, 6,627 underwent NUx only, 94 underwent NAC, and 1,984 underwent AC. The rate of NUx without perioperative chemotherapy increased from 70.8 to 78.2% (R2 = 0.632; p < 0.001). The rates of dialysis (p = 0.398), TUR-BT (p = 1.000), and radiotherapy (p = 0.497) after NUx were similar. In the Kaplan-Meier curve, the NAC and AC groups showed no significant difference (p = 0.480). In multivariate analysis, treatment with AC or NAC was not associated with OS (hazard ratio 0.83, 95% confidence interval 0.49–1.40, p = 0.477). Conclusion The use of NUx without perioperative chemotherapy has tended to increase in South Korea. Dialysis, TUR-BT, and radiotherapy rates after NUx were similar between the NAC and AC groups. There was no significant difference in OS between the NAC and AC groups. Proper perioperative chemotherapy according to patient and tumor conditions should be determined by obtaining more evidence of UTUC.https://doi.org/10.1186/s12894-022-01112-6Drug therapyUreteral neoplasmsSurvivalChemotherapyPopulation |
| spellingShingle | Jong Hyun Tae Moon Soo Ha Byung Hoon Chi 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 Neoadjuvant versus adjuvant chemotherapy in upper tract urothelial carcinoma: A nationwide cohort study BMC Urology Drug therapy Ureteral neoplasms Survival Chemotherapy Population |
| title | Neoadjuvant versus adjuvant chemotherapy in upper tract urothelial carcinoma: A nationwide cohort study |
| title_full | Neoadjuvant versus adjuvant chemotherapy in upper tract urothelial carcinoma: A nationwide cohort study |
| title_fullStr | Neoadjuvant versus adjuvant chemotherapy in upper tract urothelial carcinoma: A nationwide cohort study |
| title_full_unstemmed | Neoadjuvant versus adjuvant chemotherapy in upper tract urothelial carcinoma: A nationwide cohort study |
| title_short | Neoadjuvant versus adjuvant chemotherapy in upper tract urothelial carcinoma: A nationwide cohort study |
| title_sort | neoadjuvant versus adjuvant chemotherapy in upper tract urothelial carcinoma a nationwide cohort study |
| topic | Drug therapy Ureteral neoplasms Survival Chemotherapy Population |
| url | https://doi.org/10.1186/s12894-022-01112-6 |
| work_keys_str_mv | AT jonghyuntae neoadjuvantversusadjuvantchemotherapyinuppertracturothelialcarcinomaanationwidecohortstudy AT moonsooha neoadjuvantversusadjuvantchemotherapyinuppertracturothelialcarcinomaanationwidecohortstudy AT byunghoonchi neoadjuvantversusadjuvantchemotherapyinuppertracturothelialcarcinomaanationwidecohortstudy AT inhochang neoadjuvantversusadjuvantchemotherapyinuppertracturothelialcarcinomaanationwidecohortstudy AT taehyoungkim neoadjuvantversusadjuvantchemotherapyinuppertracturothelialcarcinomaanationwidecohortstudy AT soonchulmyung neoadjuvantversusadjuvantchemotherapyinuppertracturothelialcarcinomaanationwidecohortstudy AT tuanthanhnguyen neoadjuvantversusadjuvantchemotherapyinuppertracturothelialcarcinomaanationwidecohortstudy AT myoungsukkim neoadjuvantversusadjuvantchemotherapyinuppertracturothelialcarcinomaanationwidecohortstudy AT kyungeunlee neoadjuvantversusadjuvantchemotherapyinuppertracturothelialcarcinomaanationwidecohortstudy AT yuwonkim neoadjuvantversusadjuvantchemotherapyinuppertracturothelialcarcinomaanationwidecohortstudy AT hyunkiwoo neoadjuvantversusadjuvantchemotherapyinuppertracturothelialcarcinomaanationwidecohortstudy AT daesungkyoung neoadjuvantversusadjuvantchemotherapyinuppertracturothelialcarcinomaanationwidecohortstudy AT hasungkim neoadjuvantversusadjuvantchemotherapyinuppertracturothelialcarcinomaanationwidecohortstudy AT seyoungchoi neoadjuvantversusadjuvantchemotherapyinuppertracturothelialcarcinomaanationwidecohortstudy |