Evidence map›Paper›PMID 41219856›Full record

ArticleWorld journal of surgical oncology2025

Efficacy of radiotherapy combined with systemic therapy for retroperitoneal lymph node metastasis in upper tract urothelial carcinoma(UTUC) patients after radical nephroureterectomy.

Xiaoying Li, Xian-Shu Gao, Hongzhen Li, Mingwei Ma, Siming Li, Bing Wang, Zheng Zhang, Chunru Xu, Qi Tang, Zihao Tao and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in World journal of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Review
  2. 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

13 authors.

Xiaoying LiDepartment of Radiation Oncology, Peking University First Hospital, No.7 Xishiku Street, XichengBeijing, 100034, District, China.
Xian-Shu GaoDepartment of Radiation Oncology, Peking University First Hospital, No.7 Xishiku Street, XichengBeijing, 100034, District, China. doctorgaoxs@126.com.
Hongzhen LiDepartment of Radiation Oncology, Peking University First Hospital, No.7 Xishiku Street, XichengBeijing, 100034, District, China.
Mingwei MaDepartment of Radiation Oncology, Peking University First Hospital, No.7 Xishiku Street, XichengBeijing, 100034, District, China.
Siming LiDepartment of Renal Cancer and Melanoma, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China.
Bing WangDepartment of Urology, Peking University First Hospital- Miyun Hospital, Beijing, 101500, China.
Zheng ZhangDepartment of UrologyInstitution of UrologyBeijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University First HospitalPeking UniversityNational Urological Cancer Center, Beijing, 100034, China.
Chunru XuDepartment of UrologyInstitution of UrologyBeijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University First HospitalPeking UniversityNational Urological Cancer Center, Beijing, 100034, China.
Qi TangDepartment of UrologyInstitution of UrologyBeijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University First HospitalPeking UniversityNational Urological Cancer Center, Beijing, 100034, China.
Zihao TaoDepartment of UrologyInstitution of UrologyBeijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University First HospitalPeking UniversityNational Urological Cancer Center, Beijing, 100034, China.
Chuanliang CuiDepartment of Renal Cancer and Melanoma, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China.
Dian WangDepartment of Radiation Oncology, Rush University Medical Center, Chicago, IL, USA.
Xuesong LiDepartment of UrologyInstitution of UrologyBeijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University First HospitalPeking UniversityNational Urological Cancer Center, Beijing, 100034, China. pineneedle@sina.com.

Funding

National High Level Hospital Clinical Research FundingInterdepartmental Clinical Research Project of Peking University First Hospital 2024IR06Peking University Clinical Scientist Training Program BMU2025PYJH006
6 · The paper itself

Abstract

backgroundRetroperitoneal lymph node metastasis (rLNM) of upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU) represents a distinct metastatic state. Due to the unclear efficacy and side effects of radiotherapy in the treatment of these patients.This study aimed to assess the efficacy and adverse effects of radiotherapy combined with systemic therapy in rLNM patients after RNU.

methodsA total of 114 UTUC patients with retroperitoneal LNM after RNU were prospectively enrolled database with retroperitoneal LNM after RNU. Patients were classified by initial treatment type: (1) radiation therapy, (2) systemic therapy or (3) combination therapy. Cox proportional hazard models were used to assess the factors associated with progression free survival (PFS) and overall survival (OS). Survival curves for each group were generated and compared via the Kaplan‒Meier method.

resultsA total of 114 rLNM patients with a median recurrence-free interval of 8 months after surgery (range: 1-108) were analyzed. During the median follow-up of 22 months (range: 3-81 months), 60 patients (58.8%) developed distant metastases. The para-aortic region was the most frequent site of recurrence. The recurrence rate in this region was significantly higher in patients with renal pelvic and proximal ureteral tumors (UTUCs) than in those with middle and distal UTUCs (P = 0.046). The common iliac region was the second most common recurrence site. Compared with renal pelvic tumors, ureteral tumors were more likely to recur in the common iliac region (P = 0.001). We delineated the radiotherapy clinical target volume (CTV) on the basis of primary tumor site; only 3 patients developed in-field recurrence during follow-up.The 2-year PFS rates for the combination therapy, radiation therapy and systemic therapy groups were 65.7%, 21.1% and 20.2%, respectively (P < 0.001). The 2-year OS rates for the combination therapy, radiation therapy and systemic therapy groups were 87.9%, 48.1% and 45.6%, respectively (P < 0.001). Multivariate analysis revealed that combination therapy,radiotherapy beginning within 3 months after recurrence and maintenance therapy after radiation were independent predictors of PFS. Maintenance therapy after radiation and distant metastasis were significant predictors of OS. Among 55 patients, 1 patient (1.8%) experienced acute grade 3 adverse events during combination therapy.

conclusionsSystemic therapy and radiotherapy improved PFS compared with either therapy type alone in rLNM UTUC patients.The majority of patients experiencing only grade 1-2 gastrointestinal reactions.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsCarcinoma, Transitional CellKidney NeoplasmsNeoplasm Recurrence, LocalNephroureterectomyRetroperitoneal NeoplasmsUreteral NeoplasmsAdultAgedAged, 80 and overCombined Modality TherapyFemaleFollow-Up StudiesHumansLymphatic MetastasisLymph NodesAdverse effectPrognosisRadiotherapyRetroperitoneal lymph node metastasisUpper tract urothelial carcinoma

Identifiers

PMID41219856
PMCPMC12607141

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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.