Salvage topical therapy for upper tract urothelial carcinoma View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2018-05-26

AUTHORS

Adithya Balasubramanian, Michael J. Metcalfe, Gavin Wagenheim, Lianchun Xiao, John Papadopoulos, Neema Navai, John W. Davis, Jose A. Karam, Ashish M. Kamat, Christopher G. Wood, Colin P. Dinney, Surena F. Matin

ABSTRACT

PurposeTopical therapy (TT) for upper tract urothelial carcinoma (UTUC) has been explored as a kidney sparing approach to treat carcinoma in situ (CIS) and as adjuvant for endoscopically treated Ta/T1 tumors. In bladder cancer, data support use of salvage TT for repeat induction. We investigate the outcomes of salvage TT for UTUC in patients ineligible for or refusing nephroureterectomy.MethodsA single-center retrospective review on patients receiving salvage TT via percutaneous nephrostomy tube or cystoscopically placed ureteral catheters was performed. Primary outcome was response to therapy based on International Bladder Cancer Group criteria.Results51 patients with 58 renal units (RUs) received TT. Of these, 17 patients with 18 RUs received the second-line TT, with a median follow-up of 36.5 months (IQR 24.5–67 months). 44% (8/18) received salvage TT for refractory disease and 56% (10/18) as reinduction. 5 RUs with CIS were unresponsive to initial TT and went on to receive salvage TT, of which 20% (1/5) responded. 13 RUs recurred or relapsed following initial TT and received salvage TT for papillary tumors, with 62% (8/13) responding.ConclusionOur data provide preliminary clinical rationale for the second-line TT for refractory and recurrent, endoscopically managed papillary UTUC in patients ineligible for or refusing nephroureterectomy. However, refractory upper tract CIS appears to have poor response to salvage TT. More... »

PAGES

2027-2034

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00345-018-2349-9

DOI

http://dx.doi.org/10.1007/s00345-018-2349-9

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1104249703

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/29804202


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30 schema:description PurposeTopical therapy (TT) for upper tract urothelial carcinoma (UTUC) has been explored as a kidney sparing approach to treat carcinoma in situ (CIS) and as adjuvant for endoscopically treated Ta/T1 tumors. In bladder cancer, data support use of salvage TT for repeat induction. We investigate the outcomes of salvage TT for UTUC in patients ineligible for or refusing nephroureterectomy.MethodsA single-center retrospective review on patients receiving salvage TT via percutaneous nephrostomy tube or cystoscopically placed ureteral catheters was performed. Primary outcome was response to therapy based on International Bladder Cancer Group criteria.Results51 patients with 58 renal units (RUs) received TT. Of these, 17 patients with 18 RUs received the second-line TT, with a median follow-up of 36.5 months (IQR 24.5–67 months). 44% (8/18) received salvage TT for refractory disease and 56% (10/18) as reinduction. 5 RUs with CIS were unresponsive to initial TT and went on to receive salvage TT, of which 20% (1/5) responded. 13 RUs recurred or relapsed following initial TT and received salvage TT for papillary tumors, with 62% (8/13) responding.ConclusionOur data provide preliminary clinical rationale for the second-line TT for refractory and recurrent, endoscopically managed papillary UTUC in patients ineligible for or refusing nephroureterectomy. However, refractory upper tract CIS appears to have poor response to salvage TT.
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37 ConclusionOur data
38 Group criteria
39 T1 tumors
40 TT
41 Ta/T1 tumours
42 approach
43 bladder cancer
44 cancer
45 carcinoma
46 catheter
47 clinical rationale
48 criteria
49 data
50 data support use
51 disease
52 induction
53 kidney
54 months
55 nephrostomy tube
56 nephroureterectomy
57 outcomes
58 papillary tumors
59 patients
60 percutaneous nephrostomy tube
61 poor response
62 primary outcome
63 rationale
64 refractory
65 refractory disease
66 reinduction
67 renal units
68 repeat induction
69 response
70 retrospective review
71 review
72 salvage
73 second-line TT
74 single-center retrospective review
75 situ
76 support use
77 therapy
78 topical therapy
79 tube
80 tumors
81 units
82 upper tract urothelial carcinoma
83 ureteral catheter
84 urothelial carcinoma
85 use
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