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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients with Upper excretory tract tumors | Adult patient with Upper excretory tract tumors Neoadjuvant chemotherapy treatment received between 2010 and 2020. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Patients with Upper excretory tract tumors | Other | Standard of care for patients with Sezary Syndrome |
|
| 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 |
| Measure | Description | Time Frame |
|---|---|---|
| Progression free-survival | at one year | |
| Progression free-survival | at 2 years | |
| Progression free-survival |
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Inclusion Criteria:
Exclusion Criteria:
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Adult patients with upper excretory tract tumors
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Tiphaine LAMBERT, Dr | Contact | +33187023169 | tiphaine.lambert@aphp.fr | |
| Matthieu RESCHE-RIGON | Contact | +33142499742 | matthieu.resche-rigon@u-paris.fr |
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| ID | Term |
|---|---|
| D059039 | Standard of Care |
| ID | Term |
|---|---|
| D019984 | Quality Indicators, Health Care |
| D011787 | Quality of Health Care |
| D006298 | Health Services Administration |
| D017530 | Health Care Quality, Access, and Evaluation |
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| 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 |