TY - JOUR
T1 - Impact of lymph node dissection during surgery on the efficacy of pembrolizumab in patients with metastatic urothelial carcinoma
AU - the Japan Urological Oncology Group
AU - Kanno, Toru
AU - Ito, Katsuhiro
AU - Kita, Yuki
AU - Mochizuki, Takanori
AU - Sano, Tomoyasu
AU - Yokomizo, Akira
AU - Abe, Takashige
AU - Tsuchihashi, Kazunari
AU - Tatarano, Shuichi
AU - Inokuchi, Junichi
AU - Takahashi, Atsushi
AU - Matsui, Yoshiyuki
AU - Nishiyama, Hiroyuki
AU - Kitamura, Hiroshi
AU - Saito, Ryoichi
AU - Kobayashi, Takashi
N1 - Publisher Copyright:
© 2025 The Japanese Urological Association.
PY - 2025/5
Y1 - 2025/5
N2 - Objectives: The impact of lymph node dissection (LND) on the efficacy of pembrolizumab in patients with urothelial carcinoma (UC) who develop metastasis after surgery remains unclear. This study aimed to investigate the efficacy of pembrolizumab in patients with metastatic UC who underwent primary tumor resection with LND. Patients and methods: This retrospective study included patients who initially underwent radical surgery with or without LND for non-metastatic UC and later received pembrolizumab for recurrent lesions. Data were collected from a retrospective nationwide Japanese cohort study in patients with metastatic UC treated with pembrolizumab. The primary endpoints were overall response rate (ORR) and overall survival (OS). Multivariate analysis was performed to identify predictors of OS. Results: A total of 393 patients (273 [69.5%] underwent LND, and 120 (30.5%) did not) were included in this study. The ORRs for patients with and without LND were 30.8% and 27.3%, respectively (p = 0.460). No significant difference in OS was observed between the two groups (p = 0.471). Multivariate Cox regression analysis revealed that a neutrophil-to-lymphocyte ratio ≥3.0, Eastern Cooperative Oncology Group performance status ≥2, hemoglobin <11, and liver metastasis were associated with worse OS. However, LND was not associated with OS. Conclusions: LND during primary tumor resection did not affect the efficacy of pembrolizumab in patients with metastatic UC.
AB - Objectives: The impact of lymph node dissection (LND) on the efficacy of pembrolizumab in patients with urothelial carcinoma (UC) who develop metastasis after surgery remains unclear. This study aimed to investigate the efficacy of pembrolizumab in patients with metastatic UC who underwent primary tumor resection with LND. Patients and methods: This retrospective study included patients who initially underwent radical surgery with or without LND for non-metastatic UC and later received pembrolizumab for recurrent lesions. Data were collected from a retrospective nationwide Japanese cohort study in patients with metastatic UC treated with pembrolizumab. The primary endpoints were overall response rate (ORR) and overall survival (OS). Multivariate analysis was performed to identify predictors of OS. Results: A total of 393 patients (273 [69.5%] underwent LND, and 120 (30.5%) did not) were included in this study. The ORRs for patients with and without LND were 30.8% and 27.3%, respectively (p = 0.460). No significant difference in OS was observed between the two groups (p = 0.471). Multivariate Cox regression analysis revealed that a neutrophil-to-lymphocyte ratio ≥3.0, Eastern Cooperative Oncology Group performance status ≥2, hemoglobin <11, and liver metastasis were associated with worse OS. However, LND was not associated with OS. Conclusions: LND during primary tumor resection did not affect the efficacy of pembrolizumab in patients with metastatic UC.
KW - lymph node dissection
KW - metastatic urothelial carcinoma
KW - pembrolizumab
UR - http://www.scopus.com/inward/record.url?scp=85218812466&partnerID=8YFLogxK
U2 - 10.1111/iju.70002
DO - 10.1111/iju.70002
M3 - 学術論文
C2 - 39930591
AN - SCOPUS:85218812466
SN - 0919-8172
VL - 32
SP - 593
EP - 597
JO - International Journal of Urology
JF - International Journal of Urology
IS - 5
ER -