Prognosis of Patients Receiving Chemotherapy for Metastatic Upper Tract Urothelial Carcinoma Compared With Metastatic Urinary Bladder Cancer

Shogo Adomi; Kazutoshi Fujita; Hiroyuki Kita; Ken Kuwahara; Yasunori Akashi; Mitsuhisa Nishimoto; Naoki Matsumura; Koichi Sugimoto; Takafumi Minami; Masahiro Nozawa; Kazuhiro Yoshimura; Hideo Tahara; Akihide Hirayama; Tsukasa Nishioka; Atsunobu Esa; Hirotsugu Uemura

doi:10.21873/cdp.10244

Prognosis of Patients Receiving Chemotherapy for Metastatic Upper Tract Urothelial Carcinoma Compared With Metastatic Urinary Bladder Cancer

Cancer Diagn Progn. 2023 Jul 3;3(4):484-490. doi: 10.21873/cdp.10244. eCollection 2023 Jul-Aug.

Authors

Shogo Adomi¹, Kazutoshi Fujita¹, Hiroyuki Kita², Ken Kuwahara¹, Yasunori Akashi³, Mitsuhisa Nishimoto¹, Naoki Matsumura⁴, Koichi Sugimoto⁵, Takafumi Minami¹, Masahiro Nozawa¹, Kazuhiro Yoshimura¹, Hideo Tahara⁴, Akihide Hirayama³, Tsukasa Nishioka², Atsunobu Esa⁵, Hirotsugu Uemura¹

Affiliations

¹ Department of Urology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan.
² Izumi City General Hospital, Izumi, Japan.
³ Department of Urology, Kindai University Nara Hospital, Ikoma, Japan.
⁴ Mimihara General Hospital, Sakai, Japan.
⁵ Kaizuka City Hospital, Kaizuka, Japan.

Abstract

Background/aim: The treatment strategy for metastatic upper tract urothelial carcinoma (mUTUC) is currently based on the evidence from metastatic urinary bladder cancer (mUBC). However, some reports have shown that the outcomes of UTUC differ from those of UBC. Therefore, we retrospectively analyzed the prognosis of patients with mUBC and mUTUC treated with first-line platinum-based chemotherapy.

Patients and methods: Patients who underwent platinum-based chemotherapy at the Kindai University Hospital and affiliated hospitals between January 2010 and December 2021 were included in the study. There were 56 patients with mUBC and 73 with mUTUC. Kaplan-Meier curves were used to estimate progression-free (PFS) and overall (OS) survival. Multivariate analyses were performed using Cox proportional hazards model to predict prognostic factors.

Results: The median PFS was 4.5 and 4.0 months for the mUBC and mUTUC groups, respectively (p=0.094). The median OS was 17.0 months for both groups (p=0.821). The multivariate analysis showed no prognostic factor for PFS. The multivariate analysis for OS showed that younger age at the initiation of chemotherapy and immune checkpoint inhibitor use after first-line therapy were significantly associated with better OS.

Conclusion: Platinum-based chemotherapy had a similar effect on patients with mUTUC and mUBC.

Keywords: Metastatic upper tract urothelial carcinoma; OS; mUBC; mUTUC; metastatic urinary bladder cancer; overall survival; platinum-based chemotherapy; prognostic factor.