UNASSIGNED: Purpose There is limited evidence to support the use of adjuvant chemotherapy (AC) after radical nephroureterectomy (RNU) for upper tract @entity189 (UTUC). Against this backdrop, we hypothesized that such treatment is associated with overall survival (OS) benefit in @entity1 with locally advanced and/or positive regional @entity1600 . @entity1 and Methods Within the National @entity5 Database (2004 to 2012), we identified 3,253 individuals who received AC or observation after RNU for @entity1803 and/or pN+ UTUC. Inverse probability of treatment weighting (IPTW) -adjusted Kaplan-Meier curves and Cox proportional hazards regression analyses were used to compare OS of @entity1 in the two treatment groups. In addition, we performed exploratory analyses of treatment effect according to age, gender, Charlson comorbidity index, pathologic stage (pT3/T4N0, pT3/T4Nx and pTanyN+), and surgical margin status. Results Overall, 762 (23.42%) and 2,491 (76.58%) @entity1 with @entity1803 and/or pN+ UTUC received AC and observation, respectively, after RNU. IPTW-adjusted Kaplan-Meier curves showed that median OS was significantly longer for AC versus observation (47.41 [interquartile range,19.88 to 112.39] v 35.78 [interquartile range, 14.09 to 99.22] months; P < .001). The 5-year IPTW-adjusted rates of OS for AC versus observation were 43.90% and 35.85%, respectively. In IPTW-adjusted Cox proportional hazards regression analysis, AC was associated with a significant OS benefit (hazard ratio, 0.77 [95% CI, 0.68 to 0.88]; P < .001). This benefit was consistent across all subgroups examined (all P < .05), and no significant heterogeneity of treatment effect was observed (all Pinteraction > .05). Conclusion We report an OS benefit in @entity1 who received AC versus observation after RNU for @entity1803 and/or pN+ UTUC. Although our results are limited by the usual biases related to the observational study design, we believe that the present findings should be considered when advising post-RNU management of advanced UTUC, pending level I evidence.

Effectiveness of Adjuvant Chemotherapy After Radical Nephroureterectomy for Locally Advanced and/or Positive Regional Lymph Node Upper Tract XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity1803 :: ('7694', 'Gene') :: ['pT3/T4'] @entity5 :: ('MESH:D009369', 'Disease') :: ['Cancer'] @entity1600 :: ('MESH:D014388', 'Disease') :: ['lymph node disease'] @entity189 :: ('MESH:D002277', 'Disease') :: ['urothelial carcinoma']
@entity189 :: (MESH:D002277,Disease) :: ['Urothelial Carcinoma']
