Hereditary-like urothelial carcinomas of the upper urinary tract benefit more from adjuvant cisplatin-based chemotherapy after radical nephroureterectomy than do sporadic tumours

作者：Hollande Clemence; Colin Pierre; Rouge Thibault de la Motte; Audenet Francois; Yates David R; Phe Veronique; Ouzzane Adil; Droupy Stephane; Ruffion Alain; de La Taille Alexandre; Guy Laurent; Cussenot Olivier; Rozet Francois; Xylinas Evanguelos; Zerbib Marc; Spano Jean Philippe; Khayat David; Bitker Marc Olivier; Roupret Morgan^*

来源：BJU International, 2014, 113(4): 574-580.

DOI：10.1111/bju.12308

• ureter
• renal pelvis
• HNPCC
• chemotherapy
• urothelial carcinoma

Objective To evaluate the impact of hereditary-like' status in upper tract urothelial carcinoma (UTUC) on the survival of patients who have undergone radical nephroureterectomy (RNU) and adjuvant chemotherapy.
Patients and Methods A multicentre retrospective study was performed on all patients with high-risk UTUC who underwent RNU and adjuvant cisplatin-based chemotherapy. Using a patient risk identification tool, we distinguished tumours suspected to be hereditary from sporadic tumours and compared survival rates.
Results A total of 112 patients with a median age of 67 years were included. Hereditary-like tumour status was detected in 35 patients (31.3%), while 77 patients (68.7%) had sporadic tumours. The median age was significantly younger in the hereditary-like tumour group (56.0 vs 69.8 years, P < 0.001). Overall survival (OS) after chemotherapy was significantly better in the group with hereditary-like tumours than in the group with sporadic tumours (5-year OS: 48.2 vs 32%; P = 0.008). The cancer-specific survival (CSS) rate was significantly better in the group with hereditary-like' tumours than in the group with sporadic tumours (5-year CSS: 58 vs 35%; P = 0.006). Although there was a trend in favour of the hereditary-like tumours, we observed no significant difference regarding progression-free survival (PFS) between the two groups (5-year PFS: 71 vs 52%; P = 0.07).
Conclusion Adjuvant chemotherapy after RNU improves survival outcomes in patients with hereditary-like UTUC compared with those with sporadic tumours.

• 出版日期2014-4