|Table of Contents|

A comparison of different prophylactic intravesical chemotherapy regimens for bladder cancer recurrence after nephroureterectomy for upper tract urothelial carcinoma

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 04
Page:
712-718
Research Field:
Publishing date:

Info

Title:
A comparison of different prophylactic intravesical chemotherapy regimens for bladder cancer recurrence after nephroureterectomy for upper tract urothelial carcinoma
Author(s):
GAO Jianing; LI Hao; LIU Jingya; DING Dexin
Harbin Medical University Cancer Hospital,Heilongjiang Harbin 150081,China.
Keywords:
intravesical chemotherapy; neoplasm recurrence; nephroureterectomy; urothelial carcinoma; bladder cancer
PACS:
R737.15
DOI:
10.3969/j.issn.1672-4992.2023.04.023
Abstract:
Objective:To compare the effects of different prophylactic intravesical chemotherapy on OS,CSS and IVRFS in patients with UTUC.Methods:Clinical data of 387 UTUC patients who received RNU surgery in urology department of our hospital from 2010 to 2020 were retrospectively analyzed.The patients were followed up for 10 years after the operation to observe the survival.At the same time,the clinicopathological correlation data of the patients were statistically analyzed,and log-rank test and Kaplan-Meier method were selected.Cox regression analysis was used for univariate and multivariate survival analysis.Results:The median age of all patients was 67 years［quartile range (IQR):33~90 years］,and the median follow-up time of all patients was 44 months［quartile range (IQR):2~140 months］.There were no significant differences in baseline data among the three groups.Kaplan-Meier curves showed that there were significant differences in overall survival (OS) between the instillation group and the non-instillation group,the no-instillation group,single-instillation and multiple instillation group (P<0.000 1),and significant differences in cancer-specific survival (CSS) between the three groups (P<0.000 1).There was also a significant difference in intravesical recurrence free survival (IVRFS) between the three groups (P=0.005).The 1-year,3-year,and 5-year overall survival (OS) in the no-instillation group,single-instillation and multiple instillation group were 85.3%,70.2% and 61% vs 96.1%,84.1% and 73.5% vs 96.8%,88.5% and 84.3%,respectively.The 1-year,3-year,and 5-year cancer-specific survival (CSS) were 86.6%,73.6% and 66.6% vs 97.4%,85.2% and 74.4% vs 97.8%,89.4% and 87% in the three groups,respectively.The 1-year,3-year,and 5-year intravesical recurrence free survival (IVRFS) were 95.2%,86.7%,and 74.1% vs 98.5%,89.4%,and 81.1% vs 98.9%,94.7%,and 88%,respectively.Conclusion:Postoperative intravesical chemotherapy can significantly reduce the recurrence rate of patients with UTUC,especially for invasive or highly malignant UTUC.In addition,we suggest that multiple-instillations may be superior to single-instillations.

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