caa a22 4500 605490678 CHVBK 20210128100506.0 cr unu---uuuuu 210128e20151201xx s 000 0 eng 10.1007/s10147-015-0839-y doi (NATIONALLICENCE)springer-10.1007/s10147-015-0839-y Clinical response to induction chemotherapy predicts improved survival outcome in urothelial carcinoma with clinical lymph nodal metastasis treated by consolidative surgery [Elektronische Daten] [Shinji Urakami, Takeshi Yuasa, Shinya Yamamoto, Mizuaki Sakura, Hajime Tanaka, Tatsuro Hayashi, Sho Uehara, Yasushi Inoue, Yasuhisa Fujii, Hitoshi Masuda, Iwao Fukui, Junji Yonese] Background: To determine the indications for post-chemotherapy consolidative surgery in patients with clinical lymph node (LN) metastatic (cN+) urothelial carcinoma (UC). Methods: Sixty UC patients with measurable cN+ but without detectable systemic visceral/bone dissemination received induction platinum-based chemotherapy. Consolidative surgery was offered to all patients except for those with progressive disease. We retrospectively analyzed the clinicopathological response to induction chemotherapy and identified prognostic factors for overall survival (OS). Results: The primary cancer site was the urinary bladder in 31 patients (52%) and upper urinary tract in 29 (48%). The median number of chemotherapy courses was 4. Forty-five patients (75%) showed a clinically objective response to the induction chemotherapy. Fifty-one patients (85%) underwent subsequent consolidative surgery. Histopathological analysis indicated pT0 status in 10 (20%) and pN0 in 17 (33%). When all 60 patients were considered, clinical tumor response was found to be significantly correlated with achievement of pathological complete response. At the median follow-up of 22months, the median progression-free survival and OS periods were excellent: 18.6 and 31.6months, respectively. In the multivariate analysis, clinical tumor response was found to be an independent pre-surgical prognostic factor for OS, and pathologically negative lymph node, negative resection margin, more LNs removed, and negative lymphovascular invasion were found to be independent post-surgical prognostic parameters for OS. Conclusions: The median OS in induction chemotherapy followed by consolidative surgery was very encouraging. Our results suggest that achieving a good clinical response to pre-surgical induction chemotherapy is a good indication for subsequent consolidative surgery in UC patients with cN+ to improve OS through a good pathological response. Japan Society of Clinical Oncology, 2015 Consolidative surgery nationallicence Induction chemotherapy nationallicence Lymph node metastasis nationallicence Multimodality treatment nationallicence Urothelial carcinoma nationallicence Urakami Shinji Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, 105-8470, Tokyo, Japan aut Yuasa Takeshi Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, 105-8470, Tokyo, Japan aut Yamamoto Shinya Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, 105-8470, Tokyo, Japan aut Sakura Mizuaki Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, 105-8470, Tokyo, Japan aut Tanaka Hajime Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, 105-8470, Tokyo, Japan aut Hayashi Tatsuro Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, 105-8470, Tokyo, Japan aut Uehara Sho Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, 105-8470, Tokyo, Japan aut Inoue Yasushi Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, 105-8470, Tokyo, Japan aut Fujii Yasuhisa Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, 105-8470, Tokyo, Japan aut Masuda Hitoshi Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, 105-8470, Tokyo, Japan aut Fukui Iwao Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, 105-8470, Tokyo, Japan aut Yonese Junji Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, 105-8470, Tokyo, Japan aut International Journal of Clinical Oncology Springer Japan 20/6(2015-12-01), 1171-1178 1341-9625 20:6<1171 2015 20 10147 https://doi.org/10.1007/s10147-015-0839-y text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10147-015-0839-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Urakami Shinji Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, 105-8470, Tokyo, Japan aut NATIONALLICENCE 700 1- Yuasa Takeshi Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, 105-8470, Tokyo, Japan aut NATIONALLICENCE 700 1- Yamamoto Shinya Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, 105-8470, Tokyo, Japan aut NATIONALLICENCE 700 1- Sakura Mizuaki Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, 105-8470, Tokyo, Japan aut NATIONALLICENCE 700 1- Tanaka Hajime Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, 105-8470, Tokyo, Japan aut NATIONALLICENCE 700 1- Hayashi Tatsuro Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, 105-8470, Tokyo, Japan aut NATIONALLICENCE 700 1- Uehara Sho Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, 105-8470, Tokyo, Japan aut NATIONALLICENCE 700 1- Inoue Yasushi Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, 105-8470, Tokyo, Japan aut NATIONALLICENCE 700 1- Fujii Yasuhisa Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, 105-8470, Tokyo, Japan aut NATIONALLICENCE 700 1- Masuda Hitoshi Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, 105-8470, Tokyo, Japan aut NATIONALLICENCE 700 1- Fukui Iwao Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, 105-8470, Tokyo, Japan aut NATIONALLICENCE 700 1- Yonese Junji Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, 105-8470, Tokyo, Japan aut NATIONALLICENCE 773 0- International Journal of Clinical Oncology Springer Japan 20/6(2015-12-01), 1171-1178 1341-9625 20:6<1171 2015 20 10147