Frontiers in Oncology (Apr 2022)
Impact of Adjuvant Chemotherapy on Variant Histology of Upper Tract Urothelial Carcinoma: A Propensity Score-Matched Cohort Analysis
- Chi-Wen Lo,
- Chi-Wen Lo,
- Wei-Ming Li,
- Wei-Ming Li,
- Wei-Ming Li,
- Wei-Ming Li,
- Wei-Ming Li,
- Hung-Lung Ke,
- Hung-Lung Ke,
- Hung-Lung Ke,
- Hung-Lung Ke,
- Hung-Lung Ke,
- Yi-Huei Chang,
- Yi-Huei Chang,
- Yi-Huei Chang,
- Hsi-Chin Wu,
- Hsi-Chin Wu,
- Hsi-Chin Wu,
- I-Hsuan Alan Chen,
- Jen-Tai Lin,
- Chao-Yuan Huang,
- Chung-Hsin Chen,
- Jen-Shu Tseng,
- Jen-Shu Tseng,
- Jen-Shu Tseng,
- Wun-Rong Lin,
- Wun-Rong Lin,
- Wun-Rong Lin,
- Yuan-Hong Jiang,
- Yu-Khun Lee,
- Chung-You Tsai,
- Chung-You Tsai,
- Shiu-Dong Chung,
- Shiu-Dong Chung,
- Shiu-Dong Chung,
- Thomas Y. Hsueh,
- Thomas Y. Hsueh,
- Thomas Y. Hsueh,
- Allen W. Chiu,
- Allen W. Chiu,
- Allen W. Chiu,
- Yeong-Chin Jou,
- Yeong-Chin Jou,
- Ian-Seng Cheong,
- Ian-Seng Cheong,
- Yung-Tai Chen,
- Jih-Sheng Chen,
- Bing-Juin Chiang,
- Bing-Juin Chiang,
- Bing-Juin Chiang,
- Chih-Chin Yu,
- Chih-Chin Yu,
- Wei Yu Lin,
- Wei Yu Lin,
- Wei Yu Lin,
- Chia-Chang Wu,
- Chia-Chang Wu,
- Chuan-Shu Chen,
- Chuan-Shu Chen,
- Chuan-Shu Chen,
- Han-Yu Weng,
- Yao-Chou Tsai,
- Yao-Chou Tsai
Affiliations
- Chi-Wen Lo
- Division of Urology, Department of Surgery, Taipei Tzuchi Hospital, The Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
- Chi-Wen Lo
- School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan
- Wei-Ming Li
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Wei-Ming Li
- Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Wei-Ming Li
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Wei-Ming Li
- Department of Urology, Ministry of Health and Welfare Pingtung Hospital, Pingtung, Taiwan
- Wei-Ming Li
- Cohort Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
- Hung-Lung Ke
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Hung-Lung Ke
- Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Hung-Lung Ke
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Hung-Lung Ke
- Department of Urology, Ministry of Health and Welfare Pingtung Hospital, Pingtung, Taiwan
- Hung-Lung Ke
- Cohort Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
- Yi-Huei Chang
- Department of Urology, China Medical University Hospital, Taichung, Taiwan
- Yi-Huei Chang
- School of Medicine, China Medical University, Taichung, Taiwan
- Yi-Huei Chang
- 0Department of Urology, China Medical University Beigang Hospital, Yunlin, Taiwan
- Hsi-Chin Wu
- Department of Urology, China Medical University Hospital, Taichung, Taiwan
- Hsi-Chin Wu
- School of Medicine, China Medical University, Taichung, Taiwan
- Hsi-Chin Wu
- 0Department of Urology, China Medical University Beigang Hospital, Yunlin, Taiwan
- I-Hsuan Alan Chen
- 1Division of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Jen-Tai Lin
- 1Division of Urology, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Chao-Yuan Huang
- 2Department of Urology, National Taiwan University Hospital, College of Medicine, and National Taiwan University, Taipei, Taiwan
- Chung-Hsin Chen
- 2Department of Urology, National Taiwan University Hospital, College of Medicine, and National Taiwan University, Taipei, Taiwan
- Jen-Shu Tseng
- 3Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan
- Jen-Shu Tseng
- 4Department of Medicine, Mackay Medical College, Taipei, Taiwan
- Jen-Shu Tseng
- 5Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Wun-Rong Lin
- 3Department of Urology, MacKay Memorial Hospital, Taipei, Taiwan
- Wun-Rong Lin
- 4Department of Medicine, Mackay Medical College, Taipei, Taiwan
- Wun-Rong Lin
- 5Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Yuan-Hong Jiang
- 6Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
- Yu-Khun Lee
- 6Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
- Chung-You Tsai
- 7Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Chung-You Tsai
- 8Department of Healthcare Information and Management, Ming Chuan University, Taoyuan, Taiwan
- Shiu-Dong Chung
- 7Division of Urology, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- Shiu-Dong Chung
- 9Department of Nursing, College of Healthcare and Management, Asia Eastern University of Science and Technology, New Taipei City, Taiwan
- Shiu-Dong Chung
- 0General Education Center, Eastern University of Science and Technology, New Taipei City, Taiwan
- Thomas Y. Hsueh
- 1Division of Urology, Department of Surgery, Taipei City Hospital Renai Branch, Taipei, Taiwan
- Thomas Y. Hsueh
- 2Department of Urology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Thomas Y. Hsueh
- 3College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Allen W. Chiu
- 1Division of Urology, Department of Surgery, Taipei City Hospital Renai Branch, Taipei, Taiwan
- Allen W. Chiu
- 2Department of Urology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Allen W. Chiu
- 3College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Yeong-Chin Jou
- 4Department of Urology, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
- Yeong-Chin Jou
- 5Department of Health and Nutrition Biotechnology, Asian University, Taichung, Taiwan
- Ian-Seng Cheong
- 4Department of Urology, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi, Taiwan
- Ian-Seng Cheong
- 5Department of Health and Nutrition Biotechnology, Asian University, Taichung, Taiwan
- Yung-Tai Chen
- 6Department of Urology, Taiwan Adventist Hospital, Taipei, Taiwan
- Jih-Sheng Chen
- 6Department of Urology, Taiwan Adventist Hospital, Taipei, Taiwan
- Bing-Juin Chiang
- 7College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
- Bing-Juin Chiang
- 8Department of Urology, Cardinal Tien Hospital, New Taipei City, Taiwan
- Bing-Juin Chiang
- 9Department of Life Science, College of Science, National Taiwan Normal University, Taipei, Taiwan
- Chih-Chin Yu
- Division of Urology, Department of Surgery, Taipei Tzuchi Hospital, The Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
- Chih-Chin Yu
- School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan
- Wei Yu Lin
- 0Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Chia-Yi, Taiwan
- Wei Yu Lin
- 1Chang Gung University of Science and Technology, Chia-Yi, Taiwan
- Wei Yu Lin
- 2Department of Medicine, Chang Gung University, Taoyuan, Taiwan
- Chia-Chang Wu
- 3Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Chia-Chang Wu
- 4Taipei Medical University Research Center of Urology and Kidney (TMU-RCUK), Taipei Medical University, Taipei, Taiwan
- Chuan-Shu Chen
- 5Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
- Chuan-Shu Chen
- 6Institute of Medicine, Chung Shan Medical University, Taichung City, Taiwan
- Chuan-Shu Chen
- 7Department of Senior Citizen Service Management, National Taichung University of Science and Technology, Taichung City, Taiwan
- Han-Yu Weng
- 8Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Yao-Chou Tsai
- Division of Urology, Department of Surgery, Taipei Tzuchi Hospital, The Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
- Yao-Chou Tsai
- School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan
- DOI
- https://doi.org/10.3389/fonc.2022.843715
- Journal volume & issue
-
Vol. 12
Abstract
BackgroundThe advantage of adjuvant chemotherapy for upper urinary tract urothelial cancer (UTUC) has been reported, whereas its impact on upper tract cancer with variant histology remains unclear. We aimed to answer the abovementioned question with our real-world data.Design, Setting, and ParticipantsPatients who underwent radical nephroureterectomy (RNU) and were confirmed to have variant UTUC were retrospectively evaluated for eligibility of analysis. In the Taiwan UTUC Collaboration database, we identified 245 patients with variant UTUC among 3,109 patients with UTUC who underwent RNU after excluding patients with missing clinicopathological information.InterventionThose patients with variant UTUC were grouped based on their history of receiving adjuvant chemotherapy or not.Outcome Measurements and Statistical AnalysisPropensity score matching was used to reduce the treatment assignment bias. Multivariable Cox regression model was used for the analysis of overall, cancer-specific, and disease-free survival.Results and LimitationsFor the patients with variant UTUC who underwent adjuvant chemotherapy compared with those without chemotherapy, survival benefit was identified in overall survival in univariate analysis (hazard ratio (HR), 0.527; 95% confidence interval (CI), 0.285–0.973; p = 0.041). In addition, in multivariate analysis, patients with adjuvant chemotherapy demonstrated significant survival benefits in cancer-specific survival (OS; HR, 0.454; CI, 0.208–0.988; p = 0.047), and disease-free survival (DFS; HR, 0.324; 95% CI, 0.155–0.677; (p = 0.003). The main limitations of the current study were its retrospective design and limited case number.ConclusionsAdjuvant chemotherapy following RNU significantly improved cancer-related survivals in patients with UTUC with variant histology.
Keywords
- adjuvant chemotherapy
- nephroureterectomy
- upper urinary tract urothelial cancer
- variant histology
- UTUC
