Oncologic Outcome of Metastasectomy for Urothelial Carcinoma: Who Is the Best Candidate? View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2017-09

AUTHORS

Tohru Nakagawa, Satoru Taguchi, Atsushi Kanatani, Taketo Kawai, Masaomi Ikeda, Shinji Urakami, Akihiko Matsumoto, Yoshimitsu Komemushi, Jimpei Miyakawa, Daisuke Yamada, Motofumi Suzuki, Yutaka Enomoto, Hiroaki Nishimatsu, Yasushi Kondo, Yasushi Nagase, Yoshikazu Hirano, Toshikazu Okaneya, Yoshinori Tanaka, Hideyo Miyazaki, Tetsuya Fujimura, Hiroshi Fukuhara, Haruki Kume, Yasuhiko Igawa, Yukio Homma

ABSTRACT

BACKGROUND: Resection of metastatic lesions (metastasectomy) is performed for highly selected patients with metastatic urothelial carcinoma (mUC). This study aimed to identify the clinicopathologic factors associated with oncologic outcome for patients who underwent metastasectomy for mUC. METHODS: This analysis included 37 UC patients who underwent metastasectomy with curative intent at nine Japanese hospitals. The primary end point was cancer-specific survival. The Kaplan-Meier method with the log-rank test and the multivariable Cox proportional hazards model addressed the relationship between clinical characteristics and survival. RESULTS: Metastasectomy was performed for pulmonary (n = 23), nodal (n = 7), and other (n = 7) metastases. The median survival time was 35.4 months (interquartile range [IQR] 15.5, not reached) from the detection of metastasis and 34.3 months (IQR 13.1, not reached) from metastasectomy. The 5-year cancer-specific survival rate after detection of metastasis was 39.7%. In the multivariate analysis, the time from primary surgery to detection of metastasis (time-to-recurrence [TTR]) of 15 months or longer (hazard ratio [HR] 0.23; p = 0.0063), no symptoms of recurrence (HR 0.23; p = 0.0126), and serum C-reactive protein (CRP) levels lower than than 0.5 mg/dl (HR 0.24; p = 0.0052) were significantly associated with better survival. CONCLUSIONS: Long-term survival could be achieved for some patients with mUC who underwent metastasectomy. Lung and lymph nodes were predominant sites for metastasectomy. Symptoms, TTR, and CRP value were identified as associated with survival and should be taken into account when metastasectomy is considered. More... »

PAGES

2794-2800

Identifiers

URI

http://scigraph.springernature.com/pub.10.1245/s10434-017-5970-8

DOI

http://dx.doi.org/10.1245/s10434-017-5970-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1090375823

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28687875


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