Prognonstic impact of renin-angiotensin system blockade in localised upper-tract urothelial carcinoma

N. Tanaka, A. Miyajima, E. Kikuchi, K. Matsumoto, M. Hagiwara, H. Ide, T. Kosaka, T. Masuda, S. Nakamura, M. Oya

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: The potential role of the renin-angiotensin system (RAS) in the promotion of tumour growth has been investigated, and the administration of RAS inhibitors, such as angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs), may improve disease control in malignancy. We investigated the prognostic impact of RAS inhibitors by analysing data from patients with upper-tract urothelial carcinoma (UTUC). Methods: A total of 279 patients who underwent nephroureterectomy for localised UTUC (pTa-3N0M0) were identified at our three institutions. We retrospectively investigated the prognostic outcomes following nephroureterectomy in patients administered or not administered ACEIs or ARBs. Results: The median follow-up period was 3.4 years. RAS inhibitors were administered to 48 patients (17.2%). Multivariate analysis showed that the appearance of pathological T3, positive lymphovascular invasion, and no RAS inhibitor administration (P=0.027 HR=3.14) were independent risk factors for a decrease in subsequent metastasis-free survival. The 5-year metastasis-free survival rate was 93.0% in patients who administered RAS inhibitors, and 72.8% in their counterparts who did not (P=0.008). Conclusion: The absence of RAS inhibitor administration was an independent risk factor for subsequent tumour metastasis in patients with localised UTUC. We propose RAS inhibitors may be a potent choice as an effective treatment following nephroureterectomy.

Original languageEnglish
Pages (from-to)290-296
Number of pages7
JournalBritish Journal of Cancer
Volume106
Issue number2
DOIs
Publication statusPublished - 2012 Jan 17

Keywords

  • angiotensin II receptor blocker
  • angiotensin II-converting enzyme inhibitor
  • renin-angiotensin system
  • upper-tract urothelial carcinoma

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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