Adjuvant chemotherapy after radical nephroureterectomy does not improve survival in patients with upper tract urothelial carcinoma: a joint study by the European Association of Urology–Young Academic Urologists and the Upper Tract Urothelial Carcinoma Collaboration

• DOI: 10.1111/bju.14020
• Publication Date: 2017-09-20T14:36:54Z
• Authors: Andrea Necchi; Salvatore Lo Vullo; Luigi Mariani; Marco Moschini; Kees Hendricksen; Michael Rink; Roman Sosnowski; Jakub Dobruch; Jay D. Raman; Christopher G. Wood; Vitaly Margulis; Morgan Roupret; Alberto Briganti; Francesco Montorsi; Evanguelos Xylinas; Shahrokh F. Shariat
• Keywords: Adjuvant Chemotherapy; Upper urinary tract

To analyse the outcomes of adjuvant chemotherapy vs observation in a multicentre cohort patients with upper tract urothelial carcinoma (UTUC) order to clarify whether such benefit from after radical nephroureterectomy (RNU).Data 15 centres were collected for total 1544 patients, treated between 2000 and 2015. Criteria patient selection included pT2-4N0/x stage, or lymph node-positive disease, prior RNU. The standardized difference approach was used compare subgroup characteristics. Overall survival (OS) primary endpoint. analysis 1:1 propensity score matching, inverse probability treatment weighting addition this secondary analysis. latter also performed inclusion covariates, i.e. 'doubly robust' estimation. A 6-month landmark exclude early events.A 312 received 1232 underwent observation. Despite differences two groups, generally <10% matching. In matched no observed OS (hazard ratio [HR] 1.14, 95% confidence inverval [CI] 0.91-1.43; P = 0.268). doubly robust estimate-adjusted comparison, significantly associated shorter (HR 1.26, CI 1.02-1.54; 0.032). Similar findings confirmed analyses stratified by pathological Results should be interpreted consideration given inherent limitations retrospective studies.Adjuvant did not improve compared present study. These results contribute uncertainties regarding postoperative UTUC, suggest dedicated prospective trials, new more potent therapies, identification enhanced criteria are required.