Longitudinal Change in Renal Function During and After Perioperative Chemotherapy of Nephroureterectomy in Patients With Upper Tract Urothelial Carcinoma.

Background/Aim: Platinum-based adjuvant chemotherapy (AC) is recommended for invasive upper tract urothelial carcinoma (UTUC); however, many patients are ineligible for cisplatin due to renal impairment following radical nephroureterectomy (RNU). The optimal perioperative chemotherapy (PC) strategy for RNU remains unclear. This study focused on the impact of PC on renal function. Patients and Methods: We retrospectively evaluated patients with clinical T2-4N0M0 UTUC who underwent RNU at our institution between 2018 and 2024. Patients were stratified into three groups: AC, neoadjuvant chemotherapy (NAC), and no-PC. New baseline estimated glomerular filtration rate (NB-eGFR) was defined as the eGFR at one-month post-treatment. Longitudinal eGFR changes from NB-eGFR were assessed, and the incidence of a 20% decline in eGFR from NB-eGFR was examined. Results: A total of 27 patients were included: eight (30%) received NAC, five (19%) received AC, and 14 (51%) received no-PC. No patient received both NAC and AC. The mean NB-eGFR for the AC, NAC, and no-PC groups was 47.7, 42.3, and 40.7 ml/min/1.73 m Conclusion: Although the sample size was limited, this study suggests that PC does not significantly impair long-term renal function. Both AC and NAC appear to be viable treatment options for patients with invasive UTUC.