Neoadjuvant Chemotherapy in Upper Tract Urothelial Carcinoma : a Retrospective Multicentric Study.

Study Overview
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Brief Summary
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Upper tract urothelial carcinoma incidence is about 1 /100000/year. These tumors are mostly diagnosed at an invasive stage and the standard treatment is a total nephroureterectomy. In this population, indication of perioperative chemotherapy is still discussed. The benefit of platinum-based adjuvant chemotherapy was recently confirmed by the prospective trial POUT for pT2-T4 N0-3 M0 tumors with an improvement in recurrence-free survival of 51% in the chemotherapy arm. However, in this situation, use of adjuvant Cisplatin-based chemotherapy may be limited by the deterioration of renal function due to renal surgery. There are currently no recommendations on the place of neoadjuvant chemotherapy (NAC) with controversial results. Moreover, the impact on renal function of the NAC-NUT treatment sequence has so far been little studied. The aim of this study is to improve scientific knowledge about neoadjuvant chemotherapy in upper tract urothelial carcinoma eligible to a curative surgery. The investigators will evaluate the benefit of NAC on pathological response, overall survival and progression-free survival in a large multicentric cohort. In addition, the investigators will assess the impact of NAC on renal function at a distance from curative surgery will allow the evaluation of its specific toxicity.

Official Title
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Neoadjuvant Chemotherapy in Upper Tract Urothelial Carcinoma : a Retrospective Multicentric Study.

Conditions
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Upper Excretory Tract Tumors

Intervention / Treatment
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* Other: Patients with Upper excretory tract tumors


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients over 18 years of age Male or female Upper excretory tract tumors Localized or locally advanced stage (N0 to N1) Eligible for curative surgery Have received neoadjuvant or primary chemotherapy Neoadjuvant chemotherapy treatment received between 2010 and 2020. Exclusion Criteria: Patient's opposition to the research UTUC not eligible for curative surgery Locally advanced UTUC ≥ N2 and/or metastatic.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients with Upper excretory tract tumors<br>Adult patient with Upper excretory tract tumors Neoadjuvant chemotherapy treatment received between 2010 and 2020. | Other: Patients with Upper excretory tract tumors<br>* Standard of care for patients with Sezary Syndrome<br>* Other names: Standard of care;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pathological response rate | Pathological response rate on the surgical specimen after 4 to 6 cycles of chemotherapy (each cycle is 14 days or 21 days according to chemotherapy treatment). | immediately after the end of chemotherapy treatment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Progression free-survival |  | at one year | 
| Progression free-survival |  | at 2 years | 
| Progression free-survival |  | at 3 years | 
| Progression free-survival |  | at 4 years | 
| Radiological response rate | Radiological response rate before ablation surgery after 4-6 cycles of chemotherapy. | immediately after the end of chemotherapy treatment | 
| residual renal function assessed by creatinine clearance (mL/min) |  | at 3 months after curative surgery |