대한비뇨기종양학회지 (The Korean Journal of Urological Oncology)

  • 제16권3호
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  • Pages.89-96
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  • 2018
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  • 2234-4977(pISSN)
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  • 2233-5633(eISSN)
대한비뇨기종양학회 (Korean Urological Oncology Society)
권호 표지
DOI QR코드

DOI QR Code

상부 요로상피암에서 신보조 항암요법 및 보조 항암요법의 최신 지견

Update on Current Role of Perioperative Chemotherapy in Upper Tract Urothelial Carcinoma

  • 전병조 (고려대학교 의과대학 안산병원 비뇨기과학교실) ;
  • 태범식 (고려대학교 의과대학 안산병원 비뇨기과학교실) ;
  • 박재영 (고려대학교 의과대학 안산병원 비뇨기과학교실)
  • Jeon, Byeong Jo (Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine) ;
  • Tae, Bum Sik (Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine) ;
  • Park, Jae Young (Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine)
  • 투고 : 2018.09.27
  • 심사 : 2018.11.22
  • 발행 : 2018.12.30
⟨ 이전 논문 다음 논문 ⟩

초록

Upper tract urothelial carcinoma (UTUC) has a relatively low prevalence rate of about 1.8 per 100,000 people. According to the recent literature, the development of diagnostic techniques has gradually increased the prevalence and diagnosis rate. In the past, when UTUC was diagnosed, more than 60% of the patients were diagnosed as locally advanced or metastatic cancer. However, since 2010, approximately 70% of the patients have been diagnosed as operable stage. Although radical nephroureterectomy is known as the basis of treatment for UTUC, overall survival is poor in patients with lymph node invasion. Especially, the finding that a localized UTUC is associated with a high risk of cancer metastasis in approximately 50% of patients suggests that these patients may not have sufficient treatment through surgery alone. The European Association of Urology and the National Comprehensive Cancer Network guideline 2017 suggested that postoperative adjuvant chemotherapy may be considered in patients with advanced UTUC beyond pT2. Also, recent meta-analyses have reported that cisplatin-based adjuvant chemotherapy can be expected to have a synergistic effect of overall survival and disease-free survival. However, many patients with UTUC undergo postoperative renal failure, which may result in failure to perform cisplatin-based adjuvant chemotherapy with adequate dose. For this reason, several researchers have suggested that it is beneficial to apply neoadjuvant chemotherapy when the preoperative renal function is maintained to a certain extent. But, neoadjuvant chemotherapy has not been used by many clinicians because of the lack of studies and the rarity of the disease. We are currently discussing the outcomes and prospects of perioperative chemotherapy.

키워드

과제정보

연구 과제 주관 기관 : National Research Foundation of Korea(NRF)

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