論文

査読有り
2007年10月

Impact of multimodal treatment on survival in patients with metastatic urothelial cancer

EUROPEAN UROLOGY
  • Takashige Abe
  • ,
  • Nobuo Shinohara
  • ,
  • Toru Harabayashi
  • ,
  • Ataru Sazawa
  • ,
  • Satoru Maruyama
  • ,
  • Shin Suzuki
  • ,
  • Katsuya Nonomura

52
4
開始ページ
1106
終了ページ
1114
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1016/j.eururo.2007.02.052
出版者・発行元
ELSEVIER SCIENCE BV

Objectives: Systemic combination chemotherapy remains the mainstay of treatment for metastatic urothelial cancer. Although initial response rates are 50-70%, these responses are usually transient. The present study investigated the impact of multimodal treatment including metastasectomy on survival in patients with metastatic urothelial cancer.
Methods: Between 1989 and 2005, 48 patients with metastatic urothelial cancer underwent systemic chemotherapy at our institution. The majority received conventional cisplatin-based chemotherapy, whereas some patients underwent novel chemotherapeutic regimens mainly as salvage therapy with or without resection of metastases, aiming to improve the outcome. The relationship between clinical characteristics and survival was analyzed using the Cox proportional hazards model. The characteristics analyzed were sex, age, primary site, prior systemic chemotherapy, histology of primary lesion, white blood cell counts, hemoglobin levels, metastatic sites, total number of chemotherapy courses, and resection of the primary lesion and metastasis.
Results: Median survival-time was 17 mo (95% confidence interval, 9-27 mo) for all 48 patients. Using a multivariate model, five or more chemotherapy cycles (p = 0.0022), absence of liver, bone, and local recurrence (p = 0.0146), and resection of metastasis (p = 0.0006) were independent significant predictors of prolonged survival. Median survival time in the 12 patients with metastasectomy was 42 mo, which was significantly longer than that of patients who did not undergo metastasectomy (10 mo).
Conclusions: The number of chemotherapy cycles, sites of metastasis, and metastasectomy had an impact on survival. In selected patients, a multimodal approach including metastasectomy may contribute to long-term disease control. (c) 2007 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Web of Science ® 被引用回数 : 51

リンク情報
DOI
https://doi.org/10.1016/j.eururo.2007.02.052
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/17367917
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000249797600027&DestApp=WOS_CPL

エクスポート
BibTeX RIS