Konference: 2015 51th ASCO Annual Meeting - účast ČR
Kategorie: Genitourinární nádory
Číslo abstraktu: 4568
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. Rebecca Helen Clayman; Johannes Mischinger; M.D. Harras B. Zaid; MUDr. Jan Hrbáček; M.D. Bedeir Ali-El-Dein; Sigolene Galland; MD Kola Olugbade; M.D. Michael Rink; Dr. Hans-Martin Fristche; 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: To evaluate the impact of salvage therapy (ST) on overall survival (OS) in recurrent primary urethral cancer (PUC). Methods: A series of 154 patients (109 men, 45 women; median age: 66, IQR: 58-76) were diagnosed with PUC at ten referral centers between 1993 and 2012. Kaplan-Meier analysis with log-rank was used to estimate the impact of ST on OS. The median follow-up was 21 months (mean: 32 months; IQR: 4-48). Results: The modality of primary treatment was cystectomy+urethrectomy in 43 (27.9%), total/partial urethrectomy in 39/6 (25.3/3.9%), transurethral resection in 39 (25.3%), chemoradiotherapy (CRT), radiotherapy (RT), chemotherapy (CT) and other in 9 (5.8%), 4 (2.6%), 3 (1.9%) and 9 (5.8%) patients, respectively. Neoadjuvant CT/CRT and adjuvant CT were administered to 16/9 (10.4/5.8%) and 23 (14.9%) patients, respectively. The locations of recurrences were: urethral in 28 (18.2%), lymph nodes (LN) in 18 (11.7%), LN+distant in 12 (7.8%), LN+distant+urethral in 9 (5.8%), LN+urethral in 6 (3.9%), distant in 5 (3.3%), distant+urethral in 4 (2.6%) and no recurrence in 72 (46.8%). In the 82 patients with recurrences, the modality of ST was surgery in 32 (39.0%), RT in 8 (9.8%), surgery+RT in 5 (6.1%) and none in 37 (45.1%). The 3-year OS for patients free of any recurrence (I), with solitary and/or concomitant urethral recurrence (II) and non-urethral recurrence (III) were 86.7%, 74.5/% and 41.7% respectively (p < 0.001 for I vs. III, p = 0.001 for II vs. III, p = 0.53 for I vs. II). In patients with recurrences, those who underwent ST had similar 3-year OS (surgery: 84.9%, RT: 80%, surgery+RT: 80%) compared to patients with no recurrence (86.7%, p = 0.79), and exhibited superior 3-year OS compared to patients who did not undergo ST (27.6%; p < 0.001 compared to surgery; p = 0.016 to RT-based ST; p = 0.53 for surgery vs. RT-based ST). Receipt of perioperative CT/CRT (N = 16) did not impact on 3-year OS after ST (79.3%) compared to no CT/CRT (N = 29, 85.5%, p = 0.95). Conclusions: In this study, patients who underwent surgery or RT-based ST for recurrent PUC demonstrated improved OS compared to those who did not receive ST and exhibited similar survival to those who never developed recurrence after primary treatment.
Datum přednesení příspěvku: 1. 6. 2015