Advanced ureteral cancer with complete remission achieved by taxan containing systemic chemotherapy

We report a case of advanced ureteral cancer successfully treated with systemic chemotherapy combined with irradiation. A 47-year-old man was diagnosed as having a right ureteral cancer at the clinical stage of T4, N2 and M1 (liver). A papillary tumor was also found in the bladder and the resected specimen showed a grade 1 transitional cell carcinoma. Although three cycles of methotrexate, vinblastine, pirarubicin and cisplatin (MVAC) gave partial response to the ureteral tumor, new metastases to the lung and pelvic bone were observed. The patient received 50 Gy external irradiation to the pelvis, 11 cycles of paclitaxel (270 mg) and cisplatin (60-80 mg) followed by four cycles of docetaxel (100 mg) and cisplatin. Thereafter, he underwent bone biopsy, partial hepatectomy, total nephroureterectomy and lymph node resection, by which a complete response was achieved pathologically. The patient has been alive without evidence of disease for 12 months.