Adomi Shogo, Fujita Kazutoshi, Kita Hiroyuki, Kuwahara Ken, Akashi Yasunori, Nishimoto Mitsuhisa, Matsumura Naoki, Sugimoto Koichi, Minami Takafumi, Nozawa Masahiro, Yoshimura Kazuhiro, Tahara Hideo, Hirayama Akihide, Nishioka Tsukasa, Esa Atsunobu, Uemura Hirotsugu
Department of Urology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan.
Izumi City General Hospital, Izumi, Japan.
Cancer Diagn Progn. 2023 Jul 3;3(4):484-490. doi: 10.21873/cdp.10244. eCollection 2023 Jul-Aug.
BACKGROUND/AIM: The treatment strategy for metastatic upper tract urothelial carcinoma (mUTUC) is currently based on the evidence from metastatic urinary bladder cancer (mUBC). However, some reports have shown that the outcomes of UTUC differ from those of UBC. Therefore, we retrospectively analyzed the prognosis of patients with mUBC and mUTUC treated with first-line platinum-based chemotherapy.
Patients who underwent platinum-based chemotherapy at the Kindai University Hospital and affiliated hospitals between January 2010 and December 2021 were included in the study. There were 56 patients with mUBC and 73 with mUTUC. Kaplan-Meier curves were used to estimate progression-free (PFS) and overall (OS) survival. Multivariate analyses were performed using Cox proportional hazards model to predict prognostic factors.
The median PFS was 4.5 and 4.0 months for the mUBC and mUTUC groups, respectively (p=0.094). The median OS was 17.0 months for both groups (p=0.821). The multivariate analysis showed no prognostic factor for PFS. The multivariate analysis for OS showed that younger age at the initiation of chemotherapy and immune checkpoint inhibitor use after first-line therapy were significantly associated with better OS.
Platinum-based chemotherapy had a similar effect on patients with mUTUC and mUBC.
背景/目的:转移性上尿路尿路上皮癌(mUTUC)的治疗策略目前基于转移性膀胱癌(mUBC)的证据。然而,一些报告表明UTUC的治疗结果与UBC不同。因此,我们回顾性分析了接受一线铂类化疗的mUBC和mUTUC患者的预后。
纳入2010年1月至2021年12月在近畿大学医院及附属医院接受铂类化疗的患者。其中mUBC患者56例,mUTUC患者73例。采用Kaplan-Meier曲线评估无进展生存期(PFS)和总生存期(OS)。使用Cox比例风险模型进行多因素分析以预测预后因素。
mUBC组和mUTUC组的中位PFS分别为4.5个月和4.0个月(p = 0.094)。两组的中位OS均为17.0个月(p = 0.821)。多因素分析显示PFS无预后因素。OS的多因素分析表明,化疗开始时年龄较小以及一线治疗后使用免疫检查点抑制剂与更好的OS显著相关。
铂类化疗对mUTUC和mUBC患者的疗效相似。