Comparison of Efficacy of Adjuvant MEC (Methotrexate, Epirubicin and Cisplatin) and GC (Gemcitabine and Cisplatin) in Advanced Upper Tract Urothelial Carcinoma

Anticancer Res. 2017 Apr;37(4):1875-1883. doi: 10.21873/anticanres.11525.

Abstract

Aim: To evaluate the efficacy of methotrexate, epirubicin and cisplatin (MEC) or gemcitabine and cisplatin (GC) as adjuvant chemotherapy in advanced upper tract urothelium carcinoma (UTUC).

Patients and methods: From 2002 January to 2008 December, a total of 70 patients with advanced UTUC received radical nephroureterctomy at our Institute with MEC and GC as adjuvant chemotherapy. Disease-free survival (DFS), cancer-specific survival (CSS) and overall survival (OS) among the two groups were evaluated.

Results: The MEC (n=30) and GC group (n=40) were compared and showed no significant differences in DFS (p=0.859), CSS (p=0.722) and OS (p=0.691). Positive lymph nodes, preoperative creatinine >1.5, old age, a high ECOG state and low BMI are all the independent risk factors of poor prognosis in advanced UTUC.

Conclusion: In patients with UTUC, MEC has a non-inferior efficacy to GC in consideration of cancer recurrence, cancer-specific survival and overall survival.

Publication types

  • Comparative Study

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carcinoma, Transitional Cell / drug therapy*
  • Carcinoma, Transitional Cell / secondary
  • Chemotherapy, Adjuvant
  • Cisplatin / administration & dosage
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / analogs & derivatives
  • Epirubicin / administration & dosage
  • Female
  • Follow-Up Studies
  • Gemcitabine
  • Humans
  • Lymphatic Metastasis
  • Male
  • Methotrexate / administration & dosage
  • Middle Aged
  • Neoplasm Recurrence, Local / drug therapy*
  • Neoplasm Recurrence, Local / pathology
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Urologic Neoplasms / drug therapy*
  • Urologic Neoplasms / pathology

Substances

  • Deoxycytidine
  • Epirubicin
  • Cisplatin
  • Methotrexate
  • Gemcitabine