Radiation, Chemotherapy Not Beneficial in Localized Upper Tract Urothelial Carcinoma

While radiation and chemotherapy are not used routinely for patients who receive non-surgical treatment for localized upper tract urothelial carcinoma (UTUC), these treatments do not improve survival, according to findings from a population-based study presented at the 2019 Genitourinary Cancers Symposium.

“Understanding the impact of comorbidities, chemotherapy, and radiation on survival for localized UTUC managed without surgery has not been previously assessed and could help in counseling and decision making for patients considering a nondefinitive approach,” Jamil S. Syed, MD, of the Yale School of Medicine in New Haven, Connecticut, and colleagues wrote.

Using the National Cancer Database, Dr Syed’s team identified 28,910 with localized UTUC. Of these, 3157 (10.9%) patients, with a median age of 79 years, did not undergo definitive surgery. Instead, 294 (9.3%) underwent chemotherapy and 197 (6.3%) received radiation treatment. The median overall survival time was significantly longer for patients who were not treated with radiation compared with those who did (2.0 vs  1.4 years, P <.001). The investigators observed no overall survival differences between patients who received chemotherapy and those who did not.

Patients with high-grade tumors had significantly worse survival compared with those who did not have high-grade tumors (1.9 vs 3.8 years (P <.001).

Significant predictors of shorter overall survival included older age, male gender, greater comorbidity burden, and government health insurance, the investigators concluded

Read more of Cancer Therapy Advisor‘s coverage of the 2019 Genitourinary Cancers Symposium by visiting the conference page.

Reference

1. Syed J, Nguyen K, Javier-Desloges J, et al. The nonsurgical management of upper tract urothelial carcinoma: A role for active surveillance? Data presented at: 2019 Genitourinary Cancers Symposium; San Francisco, CA; February 14-16. Abstract 485.