865P - Adjuvant chemotherapy after radical nephroureterectomy does not improve survival in patients with upper tract urothelial carcinoma: a joint study o...

Date 10 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Cytotoxic agents
Urothelial Cancers
Genitourinary Cancers
Biological therapy
Presenter Andrea Necchi
Citation Annals of Oncology (2017) 28 (suppl_5): v295-v329. 10.1093/annonc/mdx371
Authors A. Necchi1, S. Lo Vullo2, L. Mariani2, M. Moschini3, K. Hendricksen4, M. Rink5, R. Sosnowski6, J. Dobruch7, J.D. Raman8, C.G. Wood9, V. Margulis10, M. Rouprêt11, A. Briganti12, F. Montorsi13, E. Xylinas14, S.F. Shariat15
  • 1Medical Oncology, Fondazione IRCCS - Istituto Nazionale dei Tumori, 20133 - Milan/IT
  • 2Clinical Epidemiologi And Trials Organization Unit, Fondazione IRCCS - Istituto Nazionale dei Tumori, 20133 - Milan/IT
  • 3Department Of Urology, Luzerner Kantonsspital, Luzern/CH
  • 4Urology, The Netherlands Cancer Institute, Amsterdam/NL
  • 5Urology, Universitätsklinikum Hamburg, Eppendorf/DE
  • 6Urology, European Health Centre, Otwock/PL
  • 7Urology, M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw/PL
  • 8Urology, Penn State Health Milton S. Hershey Medical Center, Hershey/US
  • 9Urology, UT M.D. Anderson Cancer Center, Houston/US
  • 10Urology, UT Southwestern Medical Center, Dallas/US
  • 11Urology, Pitié-Salpêtrière Hospital, 75651 - Paris/FR
  • 12Urology, Vita Salute San Raffaele University, Milano/IT
  • 13Urology, IRCCS San Raffaele, 20132 - Milan/IT
  • 14Urology, Cochin Hospital, Assistance-Publique Hôpitaux de Paris, Paris/FR
  • 15Urology, Medical University of Vienna, Vienna/AT



In patients (pts) with upper tract urothelial carcinoma (UTUC) the benefit of adjuvant chemotherapy (ACT) after radical nephroureterectomy (RNU) is debated. We aimed to analyze the benefit of ACT vs observation (Obs) in an international study.


Data from 15 centers was collected, totalling 1,544 pts, treated between 2000 and 2015. Criteria for pt selection were: UTUC diagnosis, pT2-4N0/x and/or pN+ stage undergoing RNU. The standardized differences (SD) approach was used to compare subgroup characteristics. Overall survival (OS) was the primary endpoint. The adopted propensity scores (PS) techniques included 1:1 PS matching and inverse probability of treatment weighting (IPTW). Additionally, the IPTW analysis was performed with the inclusion of the covariates, i.e. with doubly robust estimation (DREP). 6-month landmark analysis (LA) was also performed.


A total of 312 pts received ACT and 1,232 observations. Despite differences between the two groups, SD was generally


ACT does not improve OS compared to Obs in pT2-4 and/or pN+ UTUC. These findings contribute to the uncertainties regarding ACT in UTUC and further support the need for dedicated prospective trials in UTUC, new more potent therapies, and enhanced pt selection criteria.

Clinical trial identification

Legal entity responsible for the study

Andrea Necchi




All authors have declared no conflicts of interest.