Erschienen in:
10.01.2020 | ASO Author Reflections
ASO Author Reflections: Evaluation of Neoadjuvant Chemotherapy in the Treatment of High-Grade Upper Tract Urothelial Carcinoma
verfasst von:
Long Wang, MD
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 4/2020
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Excerpt
The POUT clinical trial demonstrated positive outcomes for adjuvant chemotherapy (AC) in the treatment of high-risk upper tract urothelial carcinoma (UTUC).
1 However, only approximately 20% of patients remain eligible for AC after definitive surgical removal of the kidney, ureter, and bladder cuff resulting from a decline in kidney function, which poses a major limitation for AC.
2 In this case, neoadjuvant chemotherapy (NAC) has become a promising addition in the multimodal treatment of UTUC. At the 2018 conference of the American Urological Association (AUA), the phase II Eastern Cooperative Oncology Group–American College of Radiology Imaging Network (ECOG-ACRIN) 8141 trial reported improvements in pathologic complete response rates with NAC
3; however, there is still currently limited utilization of NAC [1.8% of patients in the Surveillance, Epidemiology, and End Results (SEER)-Medicare database]
4 and less evidence, mainly composed of single-center studies, supporting the utilization of NAC in high-grade UTUC. …
