2026-03-10T22:43:36Z https://hirosaki.repo.nii.ac.jp/oai

oai:hirosaki.repo.nii.ac.jp:00005480 2025-08-08T01:25:37Z 557:558:955

Oncological outcomes of neoadjuvant chemotherapy in patients with locally advanced upper tract urothelial carcinoma: a multicenter study Kubota, Yuka Hatakeyama, Shingo Tanaka, Toshikazu Fujita, Naoki Iwamura, Hiromichi Mikami, Jotaro Yamamoto, Hayato Tobisawa, Yuki Yoneyama, Tohru Yoneyama, Takahiro Hashimoto, Yasuhiro Koie, Takuya Ito, Hiroyuki Yoshikawa, Kazuaki Sasaki, Atsushi Kawaguchi, Toshiaki Ohyama, Chikara Objective: The clinical impact of neoadjuvant chemotherapy (NAC) on oncological outcomes in patients with locally advanced upper tract urothelial carcinoma (UTUC) remains unclear. We investigated the oncological outcomes of platinum-based NAC for locally advanced UTUC. Results: Of 234 patients, 101 received NAC (NAC group) and 133 did not (Control [Ctrl] group). The regimens in the NAC group included gemcitabine and carboplatin (75%), and gemcitabine and cisplatin (21%). Pathological downstagings of the primary tumor and lymphovascular invasion were significantly improved in the NAC than in the Ctrl groups. NAC for locally advanced UTUC significantly prolonged recurrence-free and cancer-specific survival. Multivariate Cox regression analysis using an inverse probability of treatment weighted (IPTW) method showed that NAC was selected as an independent predictor for prolonged recurrence-free and cancer-specific survival. However, the influence of NAC on overall survival was not statistically significant. Materials and Methods: A total of 426 patients who underwent radical nephroureterectomy at five medical centers between January 1995 and April 2017 were examined retrospectively. Of the 426 patients, 234 were treated for a highrisk disease (stages cT3-4 or locally advanced [cN+] disease) with or without NAC. NAC regimens were selected based on eligibility of cisplatin. We retrospectively evaluated post-therapy pathological downstaging, lymphovascular invasion, and prognosis stratified by NAC use. Multivariate Cox regression analysis was performed for independent factors for prognosis. Conclusions: Platinum-based NAC for locally advanced UTUC potentially improves oncological outcomes. Further prospective studies are needed to clarify the clinical benefit of NAC for locally advanced UTUC. 2017-11-24 eng journal article VoR http://hdl.handle.net/10129/00006551 https://hirosaki.repo.nii.ac.jp/records/5480 10.18632/oncotarget.21551 1949-2553 ONCOTARGET 8 60 101500 101508 https://hirosaki.repo.nii.ac.jp/record/5480/files/oncotarget-101500.pdf application/pdf 3.9 MB 2019-03-08