The aim of this study was to examine the clinical presentation, treatment delivery, and cisplatin eligibility of Korean patients with urothelial carcinoma (UC) in a real-world setting.

We performed a retrospective cohort study of patients initially diagnosed with UC from March 2013 to June 2018. Creatinine clearance >60 mL/min and Eastern Cooperative Oncology Group performance status (0-1) were adopted as cisplatin eligibility criteria.

This study included 557 eligible patients. Median age was 71.0 years (range, 33-94 years), and males were dominant (80%). Primary tumor sites were: upper genitourinary tract, 18%; bladder, 81%; and urethra, 0.4%. Initial disease status was non-muscle invasive bladder cancer (313, 56%), diffuse infiltrating non-muscle invasive bladder cancer (19, 3%), cTanyN0 upper tract UC (75, 13%), cT2-4N0 bladder UC (82, 15%), TanyN1-3 UC (36, 7%), or initially metastatic UC (32, 6%). At the time of analysis (June 2019), following treatments were delivered to 134 patients with localized UC: radical operation with or without perioperative treatment (89, 67%), definitive chemoradiation (7, 5%), and palliative surgery or supportive care only (36, 28%). In total, 89 patients had metastatic UC, including those with recurrent disease (n=57), and 34 (38%) of the 89 were eligible for cisplatin.

Clinical presentations in East Asian UC patients were consistent with those of previous studies in other countries, except for a relatively high incidence of upper genitourinary tract. Our results can serve as a benchmark for further advances and future research for treatments of UC in East Asian patients.

The use of cis-platinum as therapeutic drug in malignant neoplasm has associated side effects such as nephrotoxicity and ototoxicity. The nephrotoxic effects of this drug is decreased by use of hydration method. The ototoxic effect, however, cause a irreversible sensorineural hearing loss and incidence of ototoxicity is not changed, so prevention of ototoxic effect is important.

The efficacies of fosfomycin, agent in ameliorating cisplatin induced ototoxicity, are investigated in guinea pig cochleas and the effects of pentoxifylline, agent in therapeutic drug of idiopathic sensorineural hearing loss, are evaluated anatomically by cochlear histology with scanning eletromicroscopy.

Protection against the distortion and injury of outer hair cell according to position of the cochlea caused by cicplatin was statistically significant in groups injected with fosfomycin. Also the injury of hair cells seen in groups injected with both pentoxifyllin and cisplatin was significantly higher than that of cisplatin only group.

Fosfomycin protects against cisplatin induced ototoxicity but pentoxifylline does not protect cesplatin induced ototoxicity.