Do metastatic upper tract urothelial carcinoma and bladder carcinoma have similar clinical responses to systemic chemotherapy? A Japanese multi-institutional experience

Eiji Kikuchi, Jun Miyazaki, Kazuyuki Yuge, Masayuki Hagiwara, Daishi Ichioka, Takamitsu Inoue, Susumu Kageyama, Mikio Sugimoto, Koji Mitsuzuka, Yoshiyuki Matsui, Shingo Yamamoto, Hidefumi Kinoshita, Hironobu Wakeda, Kazuya Hanai, Hiroyuki Nishiyama

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10 Citations (Scopus)

Abstract

Objective: There has been no clear evidence supporting similar chemo-responses for upper and lower urothelial carcinomas. Methods: We conducted a multicenter retrospective cohort study to analyze urothelial carcinoma patients who underwent systemic chemotherapy at 17 centers from 2004 to 2010. A total of 298 patients with either urothelial carcinoma of the bladder (N = 151) or upper tract urothelial carcinoma (N = 147) were included. Differences in tumor location (urothelial carcinoma of the bladder vs. upper tract urothelial carcinoma) were evaluated in relation to the patient backgrounds and clinical responses to systemic chemotherapy. Results: Overall 216 patients were treated with cisplatin-based chemo-regimens (gemcitabine and cisplatin in 92, or methotrexate, vinblastine, adriamycin and cisplatin/methotrexate, epirubicin and cisplatin in 124). Among 186 initially metastatic patients, the incidences of lung metastasis and liver metastasis were 39.2 and 34.1%, respectively, in upper tract urothelial carcinoma patients, and were significantly higher than those with urothelial carcinoma of the bladder (22.4% for lung; 8.4% for liver metastasis). Among 112 post-surgical recurrent/metastatic patients, agewas significantly higher and estimated glomerular filtration rate at baseline was significantly lower in upper tract urothelial carcinoma patients than those with urothelial carcinoma of the bladder. No significant differences were observed in overall clinical response rates for systemic chemotherapy between urothelial carcinoma of the bladder (45.8%) and upper tract urothelial carcinoma (38%) in initially metastatic patients or between urothelial carcinoma of the bladder (43.2%) and upper tract urothelial carcinoma (44.1%) in post-surgical recurrent/metastatic patients. Tumor location was not independently associated with cancer-specific survival in either initially metastatic or post-surgical recurrent/metastatic urothelial carcinoma patients. Conclusions: No significant differencewas observed in response rates of urothelial carcinoma of the bladder and upper tract urothelial carcinoma to systemic chemotherapy, suggesting that a similar chemo-regimen can be applied to metastatic urothelial carcinoma patients regardless of tumor location (upper vs. lower).

Original languageEnglish
Article numberhyv180
Pages (from-to)163-169
Number of pages7
JournalJapanese journal of clinical oncology
Volume46
Issue number2
DOIs
Publication statusPublished - 2016 Feb 1

Keywords

  • Bladder
  • Metastasis
  • Outcome
  • Upper urinary tract
  • Urothelial carcinoma

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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    Kikuchi, E., Miyazaki, J., Yuge, K., Hagiwara, M., Ichioka, D., Inoue, T., Kageyama, S., Sugimoto, M., Mitsuzuka, K., Matsui, Y., Yamamoto, S., Kinoshita, H., Wakeda, H., Hanai, K., & Nishiyama, H. (2016). Do metastatic upper tract urothelial carcinoma and bladder carcinoma have similar clinical responses to systemic chemotherapy? A Japanese multi-institutional experience. Japanese journal of clinical oncology, 46(2), 163-169. [hyv180]. https://doi.org/10.1093/jjco/hyv180