Outcomes of chemotherapy for upper tract urothelial carcinoma

The study period for the original cohort was between 2002 and 2018; we chose a 2-year wash-out period (2002 to 2003) and a 2-year follow-up period (2017 to 2018). All the patients had UC (International Classification of Diseases [ICD] diagnostic codes C65 [ureter], C66 [pelvis], and C67 [bladder]) between 2004 and 2016. All cases were confirmed by pathology or cytology with metastatic radiology. Inclusion criteria was the usage of GC or MVAC chemotherapy with UC diagnostic codes. Patients who were diagnosed as having other cancers within 2 years, received adjuvant or neoadjuvant chemotherapy, underwent only surgery, received other chemotherapy, and had inaccurate data were excluded. Neoadjuvant chemotherapy was defined as chemotherapy administered during 3 months before nephroureterectomy (NUx) or radical cystectomy (RCx), and adjuvant chemotherapy was defined as chemotherapy administered during 3 months after NUx or RCx. A flow chart of the study design is displayed in Fig. 1.Figure 1

Flow chart of the study design. UTUC, upper tract urothelial carcinoma; NHIS, National Health Insurance Service; AC, adjuvant chemotherapy; NAC, neoadjuvant chemotherapy; NUx, nephroureterectomy.