Format

Send to

Choose Destination
Ann Oncol. 2015 Aug;26(8):1754-9. doi: 10.1093/annonc/mdv230. Epub 2015 May 12.

Impact of perioperative chemotherapy on survival in patients with advanced primary urethral cancer: results of the international collaboration on primary urethral carcinoma.

Author information

1
Department of Urology, University of Tuebingen, Tuebingen, Germany georgios.gakis@googlemail.com.
2
Department of Urology, University of Michigan, Ann Arbor, USA.
3
Institute of Urology, USC/Norris Comprehensive Cancer Center, Los Angeles.
4
Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, USA.
5
Department of Urology, University of Tuebingen, Tuebingen, Germany.
6
2nd Medical School, Department of Urology, Charles University, Prague, Czech Republic.
7
Urology and Nephrology Center, Mansoura Clinic, Mansoura, Egypt.
8
Department of Radiooncology, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
9
Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg.
10
Department of Urology, University Hospital Regensburg, Regensburg, Germany.
11
Department of Urology, University Hospital Bern, Bern, Switzerland.

Abstract

BACKGROUND:

To investigate the impact of perioperative chemo(radio)therapy in advanced primary urethral carcinoma (PUC).

PATIENTS AND METHODS:

A series of 124 patients (86 men, 38 women) were diagnosed with and underwent surgery for PUC in 10 referral centers between 1993 and 2012. Kaplan-Meier analysis with log-rank testing was used to investigate the impact of perioperative chemo(radio)therapy on overall survival (OS). The median follow-up was 21 months (mean: 32 months; interquartile range: 5-48).

RESULTS:

Neoadjuvant chemotherapy (NAC), neoadjuvant chemoradiotherapy (N-CRT) plus adjuvant chemotherapy (ACH), and ACH was delivered in 12 (31%), 6 (15%) and 21 (54%) of these patients, respectively. Receipt of NAC/N-CRT was associated with clinically node-positive disease (cN+; P = 0.033) and lower utilization of cystectomy at surgery (P = 0.015). The objective response rate to NAC and N-CRT was 25% and 33%, respectively. The 3-year OS for patients with objective response to neoadjuvant treatment (complete/partial response) was 100% and 58.3% for those with stable or progressive disease (P = 0.30). Of the 26 patients staged ≥cT3 and/or cN+ disease, 16 (62%) received perioperative chemo(radio)therapy and 10 upfront surgery without perioperative chemotherapy (38%). The 3-year OS for this locally advanced subset of patients (≥cT3 and/or cN+) who received NAC (N = 5), N-CRT (N = 3), surgery-only (N = 10) and surgery plus ACH (N = 8) was 100%, 100%, 50% and 20%, respectively (P = 0.016). Among these 26 patients, receipt of neoadjuvant treatment was significantly associated with improved 3-year relapse-free survival (RFS) (P = 0.022) and OS (P = 0.022). Proximal tumor location correlated with inferior 3-year RFS and OS (P = 0.056/0.005).

CONCLUSION:

In this series, patients who received NAC/N-CRT for cT3 and/or cN+ PUC appeared to demonstrate improved survival compared with those who underwent upfront surgery with or without ACH.

KEYWORDS:

adjuvant; chemoradiotherapy; chemotherapy; neoadjuvant; primary urethral carcinoma

PMID:
25969370
DOI:
10.1093/annonc/mdv230
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center