The effectiveness of chemotherapy for patients with pT3N0M0 renal pelvic urothelial carcinomas: An inverse probability of treatment weighting comparison using Surveillance, Epidemiology, and End Results data

Autor: Xiangdong Li, Chaowen Huang, Jinxin Zhang, Zefu Liu, Zhouwei Liu, Jialing Huang, Yunlin Ye
Jazyk: angličtina
Rok vydání: 2020
Předmět:
0301 basic medicine
Male
Cancer Research
medicine.medical_specialty
upper urinary tract
medicine.medical_treatment
Urinary Bladder
Urology
Subgroup analysis
Kaplan-Meier Estimate
chemotherapy
Nephroureterectomy
lcsh:RC254-282
03 medical and health sciences
0302 clinical medicine
Ureter
Epidemiology
medicine
Surveillance
Epidemiology
and End Results
Confidence Intervals
Humans
Radiology
Nuclear Medicine and imaging
Kidney Pelvis
Stage (cooking)
urothelial carcinoma
Aged
Neoplasm Staging
Probability
Proportional Hazards Models
Original Research
Chemotherapy
Carcinoma
Transitional Cell
business.industry
Hazard ratio
Clinical Cancer Research
Prognosis
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Kidney Neoplasms
030104 developmental biology
medicine.anatomical_structure
Oncology
030220 oncology & carcinogenesis
Female
business
Renal pelvis
SEER Program
Zdroj: Cancer Medicine, Vol 9, Iss 16, Pp 5756-5766 (2020)
Cancer Medicine
ISSN: 2045-7634
Popis: Introduction Unlike the established evidence to use chemotherapy for urothelial carcinoma of the bladder, presently there are insufficient data to inform a recommendation on upper urinary tract urothelial carcinoma treatment. The prognosis for patients with stage T4 and positive lymph nodes is poor; however, primary tumors in the renal pelvis are associated with favorable prognoses compared to those located in the ureter. Our study aimed at investigating the effectiveness of chemotherapy in patients with pT3N0M0 renal pelvic urothelial carcinomas (RPUC) who have relative favorable prognosis. Methods Patients with pT3N0M0 tumors who underwent radical nephroureterectomy combined with bladder cuff excision between 2005 and 2014 and registered in the Surveillance, Epidemiology, and End Results database were eligible for inclusion (n = 939). Baseline characteristics between the chemotherapy and observation groups were controlled for with inverse probability of treatment weighting (IPTW)‐adjusted analysis. Results After the IPTW‐adjusted analysis, the 5‐year IPTW‐adjusted rates of overall survival (OS) for the chemotherapy and observation groups were 53.1% and 44.9%, respectively. The IPTW‐adjusted Kaplan‐Meier curves suggested that chemotherapy was associated with increased OS compared with observation (P = .028). In the IPTW‐adjusted Cox proportional hazards regression model, chemotherapy was associated with favorable survival benefits compared with observation (hazard ratio [HR] 0.71, 95% CI 0.52‐0.92, P = .031), and this was maintained after bootstrapping (HR 0.72, 95% CI 0.49‐0.93). Chemotherapy had a protective effect on OS benefits, which were found in a majority of the results of the subgroup analysis and were consistent with the main results (all P‐interactions > 0.05). Conclusion Chemotherapy may provide significant OS benefits for patients with pT3N0M0 RPUC. The results of our study could strengthen the evidence for using adjuvant chemotherapy in this rare group of patients.
Chemotherapy appears to provide significant overall survival benefits for patients with pT3N0M0 renal pelvic urothelial carcinomas. Our results showed that the effectiveness of chemotherapy is not related to the tumor size and pattern of invasion. The findings of our study could strengthen the evidence for using adjuvant chemotherapy for this rare group of patients.
Databáze: OpenAIRE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje