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ID 50719
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Author
Bekku, Kensuke
Saika, Takashi
Kioshimoto, Ryo
Kanbara, Taiki
Abstract
The clinical impact of salvage surgery after chemotherapy on cancer survival of patients with metastatic urothelial carcinoma is controversial. We aimed to verify the clinical role of salvage surgery by analyzing the long-term outcome in patients with urothelial carcinoma treated by chemotherapy. Between 2003 and 2010 at a single institution, 31 of 47 patients (66%) with metastatic urothelial carcinoma showed objective responses (CR in 4, PR in 27) after multiple courses of cisplatin/gemcitabine/paclitaxel-based chemotherapy, and a cohort of patients with partial response (PR) were retrospectively enrolled. Twelve (10 male and 2 female, median age 64.0 years) of 27 patients with PR underwent salvage surgeries after the chemotherapy: metastatectomy of residual lesions (10 retroperitoneal lymph nodes, 2 lung), and 6 radical surgeries for primary lesions as well. Progression-free survival and overall patient survival rates were analyzed retrospectively and compared with those of patients without salvage surgery. All 12 patients achieved surgical CR. Pathological findings of metastatic lesions showed viable cancer cells in 3 patients. In univariate analysis, sole salvage surgery affected overall survival in 27 patients with PR to the chemotherapy (P = 0.0037). Progression-free survival and overall survival rates in patients with salvage surgery were better than those in 15 PR patients without the surgery (39.8 vs. 0%, and 71.6 vs. 12.1% at 3 years, P = 0.01032 and 0.01048; log-rank test). Salvage surgery for patients with residual tumor who achieve partial response to chemotherapy could have a possible impact on cancer survival.
Keywords
Chemotherapy
Metastatectomy
Metastatic urothelial carcinoma
Salvage surgery
Urothelial carcinoma
Published Date
2013-02
Publication Title
International Journal of Clinical Oncology
Volume
volume18
Issue
issue1
Publisher
Springer Japan KK
Start Page
110
End Page
115
ISSN
1341-9625
Content Type
Journal Article
Official Url
http://dx.doi.org/10.1007/s10147-011-0350-z
Related Url
http://ousar.lib.okayama-u.ac.jp/metadata/50685
language
英語
File Version
author
Refereed
True
DOI
Web of Sience KeyUT