Impact of perioperative chemotherapy on survival in patients with advanced primary urethral cancer: Results of the international collaboration on primary urethral carcinoma.

Konference: 2014 50th ASCO Annual Meeting - účast ČR

Kategorie: Genitourinární nádory

Téma: Postery

Číslo abstraktu: 4587

Autoři: M.D. Georgios Gakis, F.E.B.U; M.D. Todd Matthew Morgan; M.D. Siamak Daneshmand; M.D. Kirk A. Keegan; M.D. Harras B. Zaid; MUDr. Jan Hrbáček; M.D. Bedeir Ali-El-Dein; M.D. Rebecca Helen Clayman; Lars Weissbach; M.D. Tilman Todenhoefer; Sigolene Galland; Dr. Hans-Martin Fristche; M.D. Michael Rink; M.D. Maximilian Burger; M.D. Sam Chang; prof. MUDr. Marek Babjuk, CSc.; Prof. M.D. George Niklaus Thalmann; Prof. M.D. Arnulf Stenzl; M.D. Jason Alexander Efstathiou, Ph.D.


Background: The present analysis aims to investigate the prognostic benefit of perioperative chemotherapy in patients undergoing surgery for primary urethral carcinoma. 

Methods: A total of 124 patients (86 men, 38 women) who were diagnosed with primary urethral carcinoma in ten tertiary international academic centers between 1993 and 2012, underwent surgery for primary treatment. Platinum-based neoadjuvant and adjuvant chemotherapy was administered in 18 (15%) and 21 (17%) patients, respectively. Kaplan-Meier analysis with log-rank testing was used to investigate the impact of perioperative chemotherapy on progression-free (PFS) and overall survival (OS). The median follow-up was 20 months (mean: 32 months; IQR: 4-48). 

Results: Median age at surgery was 67 years (IQR: 53-74). Receipt of neoadjuvant chemotherapy was associated with clinically node-positive tumor stage (cN+; p=0.009). Conversely, delivery of adjuvant chemotherapy was associated with locally advanced primary tumors (≥cT3; p=0.003). No further significant associations were found between perioperative chemotherapy and age, gender, tumor location (proximal vs. distal), underlying histology, tumor grade and use of palliative therapy. The 3-year PFS/3-year OS for patients with cN+-stage disease who underwent neoadjuvant chemotherapy was 40%/100%, compared to 0%/29% for no neoadjuvant chemotherapy (p=0.043 and p=0.034, respectively). By contrast, the 3-year PFS/3-year OS for patients with ≥cT3-stage disease who received adjuvant chemotherapy was 23%/46%, versus 20%/53% for no adjuvant chemotherapy (p=0.44 and p=0.20, respectively). The 3-year OS for patients with ≥cT3 and/or cN+ stage disease who received neoadjuvant chemotherapy was 100%, compared to 20% for adjuvant chemotherapy (p=0.031). 

Conclusions: In this series, patients who received neoadjuvant platinum-based chemotherapy for locally advanced primary urethral carcinoma exhibited improved survival compared to those who underwent immediate surgery and adjuvant chemotherapy.

J Clin Oncol 32:5s, 2014 (suppl; abstr 4587)

Datum přednesení příspěvku: 2. 6. 2014