Real-World Outcomes of First-Line Systematic Treatment in Locally Advanced or Metastatic Upper Urinary Tract Urothelial Carcinoma With Renal Impairment (YUSHIMA Study).

IF 1.8 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology Pub Date : 2025-06-04 DOI:10.1111/iju.70136

Tomoki Kimura, Motohiro Fujiwara, Yuya Maezawa, Kensaku Ishihara, Naoki Inoue, Kenji Tanabe, Keita Izumi, Masahiro Toide, Takanobu Yamamoto, Sho Uehara, Saori Araki, Masaharu Inoue, Ryoji Takazawa, Noboru Numao, Yukihiro Ohtsuka, Yuma Waseda, Hajime Tanaka, Soichiro Yoshida, Yasuhisa Fujii

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引用次数: 0

Abstract

Objectives: To investigate the impact of renal impairment (RI) on the efficacy of first-line chemotherapy in patients with locally advanced or metastatic upper tract urothelial carcinoma (la/mUTUC).

Methods: This multicenter retrospective study evaluated 300 patients with la/mUTUC who received GEM/CDDP or GEM/CBDCA as first-line chemotherapy. RI was defined as eGFR < 45 mL/min/1.73 m² and used to categorize patients into RI and without-RI groups. Objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) were analyzed. Multivariable Cox proportional hazard analysis was conducted to assess risk factors for PFS and OS. In the RI group, oncologic outcomes were compared between GEM/CDDP and GEM/CBDCA.

Results: Overall, 130 patients (43%) had RI, and 170 (57%) did not. During a median follow-up of 32 months, 188 patients (63%) died: 74 patients (56%) in the RI group and 114 (67%) in the without-RI group. Among 288 evaluable patients, the ORR was 34% in the RI group and 45% in the without-RI group (p = 0.072). The median PFS of the RI and without-RI groups was 5.6 and 4.8 months, respectively (p = 0.322), and the median OS was 16.9 and 14.5 months, respectively (p = 0.074). Among the RI group, no significant differences were observed between GEM/CDDP and GEM/CBDCA in PFS (6.4 vs. 4.2 months, p = 0.113) or OS (21.4 vs. 15.2 months, p = 0.142).

Conclusions: In la/mUTUC, oncologic outcomes were comparable between patients with and without RI. In the RI group, responses to GEM/CDDP and GEM/CBDCA did not differ.

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一线系统治疗局部晚期或转移性上尿路尿路上皮癌伴肾损害的真实世界结果（YUSHIMA研究）。

目的：探讨肾损害（RI）对局部晚期或转移性上尿路上皮癌（la/mUTUC）患者一线化疗疗效的影响。方法：本多中心回顾性研究评估了300例接受GEM/CDDP或GEM/CBDCA作为一线化疗的la/mUTUC患者。RI定义为eGFR 2，并用于将患者分为RI组和非RI组。分析客观缓解率（ORR）、无进展生存期（PFS）和总生存期（OS）。采用多变量Cox比例风险分析评估PFS和OS的危险因素。在RI组中，比较GEM/CDDP和GEM/CBDCA的肿瘤预后。结果：总体而言，130例患者（43%）有RI， 170例（57%）没有。在中位随访32个月期间，188例（63%）患者死亡：74例（56%）RI组和114例（67%）无RI组。在288例可评估的患者中，RI组的ORR为34%，未RI组为45% （p = 0.072）。RI组和未RI组的中位PFS分别为5.6和4.8个月（p = 0.322），中位OS分别为16.9和14.5个月（p = 0.074）。在RI组中，GEM/CDDP和GEM/CBDCA在PFS （6.4 vs 4.2个月，p = 0.113）或OS （21.4 vs 15.2个月，p = 0.142）方面无显著差异。结论：在la/mUTUC中，有和没有RI的患者的肿瘤预后是可比的。在RI组中，GEM/CDDP和GEM/CBDCA的反应没有差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Urology 医学-泌尿学与肾脏学

CiteScore

4.70

自引率

11.50%

发文量

340

审稿时长

3 months

期刊介绍： International Journal of Urology is the official English language journal of the Japanese Urological Association, publishing articles of scientific excellence in urology. Submissions of papers from all countries are considered for publication. All manuscripts are subject to peer review and are judged on the basis of their contribution of original data and ideas or interpretation.