421 UPPER URINARY TRACT UROTHELICAL CARCINOMA WITH LOCOREGIONAL NODAL METASTASES: EXPERIENCE WITH AGGRESSIVE INTEGRATION OF SYSTEMIC THERAPY FOLLOWED BY RADICAL NEPHROURETERECTOMY
Bibliographic record
Abstract
You have accessJournal of UrologyUrothelial Cancer: Upper Tract Tumors1 Apr 2010421 UPPER URINARY TRACT UROTHELICAL CARCINOMA WITH LOCOREGIONAL NODAL METASTASES: EXPERIENCE WITH AGGRESSIVE INTEGRATION OF SYSTEMIC THERAPY FOLLOWED BY RADICAL NEPHROURETERECTOMY Ramy Youssef, Shahrokh Shariat, Yair Lotan, Christopher Wood, Arthur Sagalowsky, Richard Zigeuner, Eiji Kikuchi, Alon Weizer, Jay Raman, Mesut Remzi, Marco Roscigno, Francesco Montorsi, Christian Bolenz, Wassim Kassouf, and Vitaly Margulis Ramy YoussefRamy Youssef Dallas, TX More articles by this author , Shahrokh ShariatShahrokh Shariat Dallas, TX More articles by this author , Yair LotanYair Lotan Dallas, TX More articles by this author , Christopher WoodChristopher Wood Houston, TX More articles by this author , Arthur SagalowskyArthur Sagalowsky Dallas, TX More articles by this author , Richard ZigeunerRichard Zigeuner Graz, Austria More articles by this author , Eiji KikuchiEiji Kikuchi Tokyo, Japan More articles by this author , Alon WeizerAlon Weizer Ann Arbor, TX More articles by this author , Jay RamanJay Raman New York, NY More articles by this author , Mesut RemziMesut Remzi Vienna, Austria More articles by this author , Marco RoscignoMarco Roscigno Milan, Italy More articles by this author , Francesco MontorsiFrancesco Montorsi Milan, Italy More articles by this author , Christian BolenzChristian Bolenz Mannheim, Germany More articles by this author , Wassim KassoufWassim Kassouf Montreal, Cape Verde More articles by this author , and Vitaly MargulisVitaly Margulis Dallas, TX More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.491AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Based on experience with advanced urothelial carcinoma (UC) of the urinary bladder, neoadjuvant systemic therapy is an attractive treatment paradigm for patients with UC of the upper urinary tract. Herein we describe a multi-center experience with administration of neoadjuvant platinum-based chemotherapy in upper tract UC (UTUC) patients with loco-regional nodal metastases. METHODS We selected 313 patients from UTUC Collaboration (over 1200 patients), who underwent radical nephro-ureterctomy (RNU) with concomitant retroperitoneal lymph node dissection between 1990 and 2007 and met the criteria for one of 3 groups. Group 1 comprised patients who received neoadjuvant chemotherapy before RNU due to biopsy proven loco-regional metastases. Group 2 consisted of patients who underwent primary RNU and were found to have metastatic nodal disease on final pathologic review. Group 3 comprised a comparative cohort of patients treated with primary RNU for locally advanced (pT2/pT4) node negative UTUC. RESULTS Group 1, 2 and 3 included 18, 120 and 175 patients respectively. The 5 year disease-free survival rate was 49%, 30% and 64%, while the 5 year cancer specific survival rate was 44%, 36%and 69% in groups 1, 2 and 3 respectively. In group 1, on final pathological evaluation 9 patients (50 %) were pN0, 6 patients (33%) were pT0 and 5 patients (28%) had pT0pN0 disease. Kaplan-Meyer survival analyses demonstrated similar recurrence and survival rates in group 1 compared to group 3 (p=0.14 and 0.06, respectively). Meanwhile, group 2 had significantly inferior recurrence and survival rates compared to group 3 (p<0.001 and <0.001, respectively) and compared to group 1 (p=0.04 and 0.06, respectively). CONCLUSIONS Neoadjuvant systemic therapy followed by aggressive surgical consolidation may improve the oncologic outcome in UTUC patients with regional nodal metastases. This data supports further evaluation of neoadjuvant systemic therapy in patients with locally advanced UTUC. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e166 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ramy Youssef Dallas, TX More articles by this author Shahrokh Shariat Dallas, TX More articles by this author Yair Lotan Dallas, TX More articles by this author Christopher Wood Houston, TX More articles by this author Arthur Sagalowsky Dallas, TX More articles by this author Richard Zigeuner Graz, Austria More articles by this author Eiji Kikuchi Tokyo, Japan More articles by this author Alon Weizer Ann Arbor, TX More articles by this author Jay Raman New York, NY More articles by this author Mesut Remzi Vienna, Austria More articles by this author Marco Roscigno Milan, Italy More articles by this author Francesco Montorsi Milan, Italy More articles by this author Christian Bolenz Mannheim, Germany More articles by this author Wassim Kassouf Montreal, Cape Verde More articles by this author Vitaly Margulis Dallas, TX More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".