The Prognostic Factor Analysis and Effect of Adjuvant M-VAC Chemotherapy on Advanced Transitional Cell Carcinoma of the Upper Urinary Tract

Moon, Jang Hwan; Song, Ki Hak; Song, Jaemann

Abstract

PURPOSE: We evaluated the prognostic factors affecting the patients' survival and analyzed the effect of the adjuvant M-VAC chemotherapy after nephroureterectomy for patients with advanced (T3, T4) transitional cell carcinoma (TCC) of the upper urinary tract (UUT) with compared to surgery only group.
MATERIALS AND METHODS
Of 33 patients diagnosed with upper urinary tract transitional cell carcinoma at our institution from 1988 to 1999, 20 patients with advanced transitional cell carcinoma of the renal pelvis and ureter underwent nephroureterectomy and follow-up. 5 patinets were treated nephroureterectomy only, and 15 patients were treated with nephroureterectomy plus adjuvant M-VAC chemotherapy. Prognostic factors such as age, bladder invasion, IVP finding, tumor stage, tumor grade, and tumor multiplicity were investigated.
RESULTS
The mean age was 61 years old (38-75). The tumor stage (T3; 10 cases, T4; 10 cases) was not of benefit in predicting survival. Other prognostic factor such as bladder invasion, IVP finding, tumor multiplicity were not correlated with survival rate. The treatment method (nephroureterectomy only group-13.2 months vs. adjuvant M-VAC group-115 months), and tumor grade (GII; 12 cases, 39.2 months vs. GIII; 8 cases, 16.3 months) has significant prognostic value in survival rate.
CONCLUSIONS
Many prognostic factors such as age, bladder invasion, IVP finding, stage and tumor multiplicity have no influence on the survival of patients with UUT TCC while tumor grade seems to be correlated with the survival. Survival rate of studied M-VAC group is superior to that of control surgery-only group. So adjuvant M-VAC chemotherapy is the valuable and tolerable treatment moldality in order to prolong the survival time for the patients with high stage UUT TCC.