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Site-Specific Differences of Eligibility for Adjuvant Immunotherapy Among Urothelial Carcinoma Patients Treated With Radical Surgery: Results From a Multicenter Cohort Study.
Narita, Chisato; Urabe, Fumihiko; Fukuokaya, Wataru; Iwatani, Kosuke; Imai, Yu; Yasue, Keiji; Mori, Keiichiro; Aikawa, Koichi; Yanagisawa, Takafumi; Kimura, Shoji; Tashiro, Kojiro; Tsuzuki, Shunsuke; Yamada, Yuta; Yuen, Steffi Kar Kei; Teoh, Jeremy Yuen-Chun; Shimomura, Tatsuya; Yamada, Hiroki; Furuta, Akira; Miki, Jun; Kimura, Takahiro.
Afiliación
  • Narita C; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
  • Urabe F; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan. Electronic address: furabe0809@gmail.com.
  • Fukuokaya W; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
  • Iwatani K; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan; Department of Urology, Jikei University Kashiwa Hospital, Chiba, Japan.
  • Imai Y; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
  • Yasue K; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
  • Mori K; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
  • Aikawa K; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
  • Yanagisawa T; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
  • Kimura S; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan; Department of Urology, Jikei University Kashiwa Hospital, Chiba, Japan.
  • Tashiro K; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan; Department of Urology, Jikei Katsushika Medical Center, Tokyo, Japan.
  • Tsuzuki S; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
  • Yamada Y; Department of Urology, University of Tokyo, Tokyo, Japan.
  • Yuen SKK; S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China.
  • Teoh JY; S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China.
  • Shimomura T; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
  • Yamada H; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan; Department of Urology, Jikei Katsushika Medical Center, Tokyo, Japan.
  • Furuta A; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
  • Miki J; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan; Department of Urology, Jikei University Kashiwa Hospital, Chiba, Japan.
  • Kimura T; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.
Clin Genitourin Cancer ; 22(3): 102082, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38641443
ABSTRACT

BACKGROUND:

The CheckMate274 trial has reported enhanced disease-free survival rates in patients with stage pT3-4/ypT2-4 or pN+ urothelial carcinoma (UC) undergoing adjuvant nivolumab therapy. This study compares prognostic differences between urothelial carcinoma of the bladder (UCB) and upper tract urothelial carcinoma (UTUC).

METHODS:

We retrospectively analyzed data from 719 patients with UC who underwent radical surgery, stratifying to patients at stage pT3-4 and/or pN+ without neoadjuvant chemotherapy (NAC) or at ypT2-4 and/or ypN+ with NAC (potential candidates for adjuvant immunotherapy), and to those who were not candidates for adjuvant immunotherapy. We used Kaplan-Meier curves to assess oncological outcomes, particularly nonurothelial tract recurrence-free survival (NUTRFS), cancer-specific survival (CSS), and overall survival (OS). Risk factors were identified by Cox regression analysis.

RESULTS:

Kaplan-Meier curves showed significantly lower NUTRFS, CSS, and OS for potential adjuvant immunotherapy candidates than for noncandidates in each UCB and UTUC group. NUTRFS, CSS, and OS did not differ significantly between adjuvant immunotherapy candidates with UBC or UTUC. Trends were similar among patients ineligible for adjuvant immunotherapy. Pathological T stage (pT3-4 or ypT2-4), pathological N stage, and lymphovascular invasion (LVI) were independent predictors of oncological outcomes on multivariate analysis.

CONCLUSION:

The criteria for adjuvant immunotherapy candidates from the CheckMate 274 trial can also effectively stratify UC patients after radical surgery. Substantial clinical significance is attached to LVI status as well as to pathological T and N status, suggesting that LVI status should be considered when selecting suitable candidates for adjuvant immunotherapy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Vejiga Urinaria / Carcinoma de Células Transicionales Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Genitourin Cancer Asunto de la revista: NEOPLASIAS / UROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
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XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Vejiga Urinaria / Carcinoma de Células Transicionales Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Genitourin Cancer Asunto de la revista: NEOPLASIAS / UROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Estados Unidos