Diversity in treatment modalities of Stage II/III urothelial cancer in Japan: sub-analysis of the multi-institutional national database of the Japanese Urological Association

We aimed to survey treatment modalities for the patients with Stage II/III urothelial cancer in Japan.

We used the multi-institutional national database of the Japanese Urological Association from 348 Japanese institutions, in which a total of 3707 patients with muscle-invasive bladder cancer and 1538 with upper urinary tract urothelial carcinoma were registered in 2008 and 2011, respectively.

Primary treatment was classified as surgery alone, surgery with chemotherapy, surgery with radiation, radiation alone, chemotherapy alone, combination of radiation and chemotherapy and observation. Overall and cancer-specific survivals were examined using the Kaplan-Meier method, and survival in the subgroups was analyzed using the log-rank test.

In Stage II/III bladder cancer patients, 49. 7% of those were treated with radical operation and 22. 3% received observation only. A total 97. 2% of Stage II/III upper urinary tract urothelial carcinoma patients treated with radical surgery. A total 30. 4% of Stage II/III bladder cancer patients received chemotherapy. Majority of the patients received cisplatin-based regimen, however, regimens of chemotherapy was rich in variety up to 13 regimens. Chemotherapy regimens for the patients with upper urinary tract urothelial carcinoma were also various up to eight regimens. Overall and cancer-specific survivals were statistically significantly stratified according to the clinical stage. The upper urinary tract urothelial carcinoma patients diagnosed with clinical stage T3 had significantly poor prognosis compared with those diagnosed with clinical stage T2.

This study demonstrated the variety of treatments used for Japanese patients with Stage II/III urothelial cancer. Treatment standardization for these entities may be necessary.

Japanese journal of clinical oncology. 2016 Feb 06 [Epub ahead of print]

Takuya Koie, Chikara Ohyama, Hiroyuki Fujimoto, Hiroyuki Nishiyama, Jun Miyazaki, Shiro Hinotsu, Eiji Kikuchi, Mizuaki Sakura, Junichi Inokuchi, Tomohiko Hara, Cancer Registration Committee of the Japanese Urological Association

Working Group of the Upper Urinary Tract Urothelial Carcinoma (UTUC) Registration Committee of the Japanese Urological Association Department of Urology, Hirosaki University Graduate School of Medicine, Aomori. , Working Group of the Upper Urinary Tract Urothelial Carcinoma (UTUC) Registration Committee of the Japanese Urological Association Department of Urology, Hirosaki University Graduate School of Medicine, Aomori  Working Group of the Upper Urinary Tract Urothelial Carcinoma (UTUC) Registration Committee of the Japanese Urological Association Urology Division, National Cancer Center Hospital, Tokyo. , Working Group of the Upper Urinary Tract Urothelial Carcinoma (UTUC) Registration Committee of the Japanese Urological Association Department of Urology, Faculty of Medicine, University of Tsukuba, Ibaraki. , Working Group of the Upper Urinary Tract Urothelial Carcinoma (UTUC) Registration Committee of the Japanese Urological Association Department of Urology, Faculty of Medicine, University of Tsukuba, Ibaraki. , Working Group of the Upper Urinary Tract Urothelial Carcinoma (UTUC) Registration Committee of the Japanese Urological Association Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama. , Working Group of the Upper Urinary Tract Urothelial Carcinoma (UTUC) Registration Committee of the Japanese Urological Association Department of Urology, Keio University School of Medicine, Tokyo. , Working Group of the Upper Urinary Tract Urothelial Carcinoma (UTUC) Registration Committee of the Japanese Urological Association Department of Urology, Cancer Institute Hospital, Japanese Foundation of Cancer Research, Tokyo. , Working Group of the Upper Urinary Tract Urothelial Carcinoma (UTUC) Registration Committee of the Japanese Urological Association Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. , Working Group of the Upper Urinary Tract Urothelial Carcinoma (UTUC) Registration Committee of the Japanese Urological Association Urology Division, National Cancer Center Hospital, Tokyo.

PubMed