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Adjuvant Chemotherapy after Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma with Variant Histology: A Systematic Review and Meta-Analysis of Survival Outcomes

Authors
 Jinhyung Jeon  ;  Jae Heon Kim  ;  Jee Soo Ha  ;  Won Jae Yang  ;  Kang Su Cho  ;  Do Kyung Kim 
Citation
 UROLOGIA INTERNATIONALIS, Vol.108(4) : 339-348, 2024-08 
Journal Title
UROLOGIA INTERNATIONALIS
ISSN
 0042-1138 
Issue Date
2024-08
MeSH
Carcinoma, Transitional Cell* / drug therapy ; Carcinoma, Transitional Cell* / mortality ; Carcinoma, Transitional Cell* / pathology ; Carcinoma, Transitional Cell* / surgery ; Chemotherapy, Adjuvant ; Humans ; Kidney Neoplasms* / drug therapy ; Kidney Neoplasms* / mortality ; Kidney Neoplasms* / pathology ; Kidney Neoplasms* / surgery ; Nephroureterectomy* ; Survival Rate ; Treatment Outcome ; Ureteral Neoplasms* / drug therapy ; Ureteral Neoplasms* / mortality ; Ureteral Neoplasms* / pathology ; Ureteral Neoplasms* / surgery
Keywords
Adjuvant chemotherapy ; Chemotherapy ; Survival ; Upper tract urothelial carcinoma ; Variant histology
Abstract
Introduction: The objective of this study was to determine effects of adjuvant chemotherapy (AC) on survival outcomes compared to surgery alone without AC for upper tract urothelial carcinoma (UTUC) patients with variant histology (VH). Methods: We conducted a systematic review and meta-analysis of studies investigating AC for UTUC in Medline, Embase, the Cochrane Library up to January 2023. Population, intervention, comparator, and outcome were UTUC patients with VH, radical nephroureterectomy with AC, radical nephroureterectomy only, and oncological survival, respectively. Results: Four retrospective studies were included. Regarding overall survival (OS), the pooled hazard ratio was 0.61 (95% confidence interval: 0.42-0.87; p = 0.007) across two studies. Regarding cancer-specific survival (CSS), the pooled hazard ratio was 0.46 (95% confidence interval: 0.25-0.84; p = 0.01) across three studies. All included studies had a high quality based on the Newcastle-Ottawa Scale. Certainty of evidence for OS was low. Certainty of evidence for CSS was moderate due to a strong association (hazard ratio <0.5). Publication bias was not significant for any studies. Conclusion: In UTUC patients with VH, administration of AC after surgery might have better survival outcomes than surgery alone. Our study provides evidence for decision-making of clinicians who treat UTUC patients with VH.
Full Text
https://karger.com/uin/article-abstract/108/4/339/906280
DOI
10.1159/000538545
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Kyung(김도경)
Jeon, Jinhyung(전진형)
Cho, Kang Su(조강수) ORCID logo https://orcid.org/0000-0002-3500-8833
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/200451
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