Evidence map›Paper›PMID 40251401›Full record

ArticleWorld journal of urology2025

Combined neoadjuvant and adjuvant therapy versus adjuvant therapy in high-risk upper tract urothelial carcinoma: a propensity matched multicenter analysis (ROBUUST 2.0 International Collaborative Group).

Ahmed Eraky, Reuben Ben-David, Gabriele Bignante, Zhenjie Wu, Linhui Wang, Randall Lee, Andres F Correa, Daniel D Eun, Alessandro Antonelli, Alessandro Veccia and 32 more

Abstract readMulticenter StudyComparative Study
PubMed Publisher
In one paragraph

Article in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

42 authors.

Ahmed ErakyDepartment of Urology, Icahn School of Medicine at Mount Sinai Hospital, One Gustave L. Levy Place, Box 1272, New York, NY, 10029, USA.
Reuben Ben-DavidDepartment of Urology, Icahn School of Medicine at Mount Sinai Hospital, One Gustave L. Levy Place, Box 1272, New York, NY, 10029, USA.
Gabriele BignanteDepartment of Urology, Rush University, Chicago, IL, USA.
Zhenjie WuDepartment of Urology, Changhai Hospital, Naval Medical University, Shanghai, China.
Linhui WangDepartment of Urology, Changhai Hospital, Naval Medical University, Shanghai, China.
Randall LeeFox Chase-Temple Urologic Institute, Philadelphia, PA, USA.
Andres F CorreaFox Chase-Temple Urologic Institute, Philadelphia, PA, USA.
Daniel D EunFox Chase-Temple Urologic Institute, Philadelphia, PA, USA.
Alessandro AntonelliDepartment of Urology, University of Verona, Verona, Italy.
Alessandro VecciaDepartment of Urology, University of Verona, Verona, Italy.
Francesco DitonnoDepartment of Urology, University of Verona, Verona, Italy.
Firas AbdollahVattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA.
Alex StephensVattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA.
Shane TinsleyVattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA.
Daniel SidhomDepartment of Urology, Indiana University, Indianapolis, IN, USA.
Chandru P SundaramDepartment of Urology, Indiana University, Indianapolis, IN, USA.
Sol C MoonDepartment of Urology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA.
Soroush Rais-BahramiDepartment of Urology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL, USA.
Mark L GonzalgoDesai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
Omri Falik NativDesai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
Francesco PorpigliaDivision of Urology, University of Turin, San Luigi Gonzaga Hospital, Turin, Italy.
Daniele AmparoreDivision of Urology, University of Turin, San Luigi Gonzaga Hospital, Turin, Italy.
Enrico CheccucciDivision of Urology, University of Turin, San Luigi Gonzaga Hospital, Turin, Italy.
Antonio TufanoIstituto Nazionale Tumori Di Napoli, IRCCS "Fondazione G. Pascale", Naples, Italy.
Sisto PerdonàIstituto Nazionale Tumori Di Napoli, IRCCS "Fondazione G. Pascale", Naples, Italy.
Stephan BrönimannSchool of Medicine, Brady Urological Institute, Johns Hopkins Medicine, Baltimore, MD, USA.
Nirmish SinglaSchool of Medicine, Brady Urological Institute, Johns Hopkins Medicine, Baltimore, MD, USA.
Ottavio De CobelliDivision of Urology, European Institute of Oncology (IEO)-IRCCS, Milan, Italy.
Matteo FerroDivision of Urology, European Institute of Oncology (IEO)-IRCCS, Milan, Italy.
Giuseppe SimoneDepartment of Urology, IRCCS "Regina Elena" National Cancer Institute, Rome, Italy.
Gabriele TudertiDepartment of Urology, IRCCS "Regina Elena" National Cancer Institute, Rome, Italy.
Margaret F MeagherDepartment of Urology, UC San Diego School of Medicine, La Jolla, CA, USA.
Ithaar H DerweeshDepartment of Urology, UC San Diego School of Medicine, La Jolla, CA, USA.
Takashi YoshidaDepartment of Urology and Andrology, Kansai Medical University, Osaka, Japan.
Hidefumi KinoshitaDepartment of Urology and Andrology, Kansai Medical University, Osaka, Japan.
Raj BhanvadiaDepartment of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Ali H ZahalkaDepartment of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Vitaly MargulisDepartment of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Farshad S MoghaddamNorris Comprehensive Cancer Center, Institute of Urology, University of Southern California, Los Angeles, CA, USA.
Hooman DjaladatNorris Comprehensive Cancer Center, Institute of Urology, University of Southern California, Los Angeles, CA, USA.
Riccardo AutorinoDepartment of Urology, Rush University, Chicago, IL, USA.
Reza MehrazinDepartment of Urology, Icahn School of Medicine at Mount Sinai Hospital, One Gustave L. Levy Place, Box 1272, New York, NY, 10029, USA. reza.mehrazin@mountsinai.org.ORCID http://orcid.org/0009-0007-8648-0410

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe efficacy of combined neoadjuvant and adjuvant therapy (CNAT) in upper tract urothelial carcinoma (UTUC) remains unclear despite its demonstrated potential in bladder urothelial carcinoma. High-risk features- clinical stage ≥ T3, node-positive disease, multifocality, high-grade pathology, hydronephrosis, and large tumor size - are associated with poor prognosis in UTUC. We investigated the oncological outcomes of CNAT versus adjuvant therapy (AT) alone in high-risk UTUC patients. MATERIALS AND

methodsWe analyzed perioperative data from 2433 patients with UTUC (2015-2023) across 17 centers in the US, Europe, and Asia. Propensity score matching was performed using preoperative clinical T and N stages. Kaplan-Meier curves and Cox proportional hazards models were used to evaluate overall survival (OS), cancer-specific survival (CSS), recurrence-free survival (RFS), and metastasis-free survival (MFS).

resultsAmong 285 high-risk UTUC patients, 76 matched patients (38 CNAT, 38 AT) were analyzed after matching, with a median follow-up of 15 months. CNAT and AT groups had comparable oncological outcomes: 2-year OS (72.9% vs. 71.8%; p = 0.89), CSS (76.7% vs. 75.3%; p = 0.92), RFS (30.1% vs. 39%; p = 0.97), or MFS (45.5% vs. 44.7%; p = 0.91), respectively. Cox regression showed no significant survival benefit of CNAT over AT after adjusting for clinical and pathological factors (HR for OS: 1.06; p = 0.9).

conclusionIn this large multicenter international cohort, our findings suggest that CNAT does not provide a clear advantage over AT alone in patients with high-risk UTUC. Prospective randomized trials are needed to clarify the role of multimodal therapy in UTUC management.

Indexed as

Carcinoma, Transitional CellKidney NeoplasmsNeoadjuvant TherapyUreteral NeoplasmsAgedChemotherapy, AdjuvantFemaleHumansMaleMiddle AgedPropensity ScoreRetrospective StudiesTreatment OutcomeAdjuvantNeoadjuvantRecurrenceSurvivalUTUC

Identifiers

PMID40251401

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.