Qi N N, Li T, Ning X H, Chen J C, Cai L, Gong K
Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing 100034, China.
Zhonghua Yi Xue Za Zhi. 2017 Mar 28;97(12):940-943. doi: 10.3760/cma.j.issn.0376-2491.2017.12.013.
To investigate the clinical manifestation, diagnosis, treatment and outcome of simultaneous occurrence of renal cell carcinoma and urothelial carcinoma. Twenty-four consecutive patients with synchronous renal cell carcinoma and urothelial carcinoma treated in our center from March 2005 to December 2015 were retrospectively reviewed. Their clinical, pathological and prognostic features were evaluated. Kaplan-Meier curves were used to estimate overall survival. Patient' age was range from 48 to 79 yrs (median 69.5). Fourteen patients presented with macroscopic hematuria, and 10 patients were asymptomatic. B-ultrasound, computed tomography (CT) and cystoscopy initially indicated renal cell carcinoma concurrent with ipsilateral upper urinary tract urothelial carcinoma (UTUC) in 4 cases, renal cell carcinoma concurrent with bladder tumor in 16 cases, renal cell carcinoma concurrent with both ipsilateral UTUC and bladder tumor in 1 case, renal cell carcinoma in 2 cases and ureter carcinoma in 1 case. Different treatments were performed. The median follow-up time after surgery was 22.5 months. For patients with synchronous renal cell carcinoma and bladder tumor, there was no significant survival difference between patients treated with partial nephrectomy or radical nephrectomy. During follow up, 3 patients died of renal cell carcinoma, 3 patients died of non-oncological disease and 1 patient died of ureter carcinoma. The 3-year overall survival rate was 82.7%. For patients with synchronous renal cell carcinoma and bladder tumor, there was no significant survival difference between patients treated with partial nephrectomy or radical nephrectomy (=0.874). Concurrence of renal cell carcinoma and urothelial carcinoma is clinically rare. Treatments should be individualized. The prognosis for a patient with synchronous renal cell carcinoma and urothelial carcinoma is associated with the more aggressive one.
探讨肾细胞癌与尿路上皮癌同时发生的临床表现、诊断、治疗及预后。回顾性分析2005年3月至2015年12月在本中心接受治疗的24例同步性肾细胞癌与尿路上皮癌患者。评估其临床、病理及预后特征。采用Kaplan-Meier曲线评估总生存率。患者年龄48至79岁（中位年龄69.5岁）。14例患者出现肉眼血尿，10例患者无症状。B超、计算机断层扫描（CT）及膀胱镜检查最初提示4例为肾细胞癌合并同侧上尿路尿路上皮癌（UTUC），16例为肾细胞癌合并膀胱肿瘤，1例为肾细胞癌合并同侧UTUC及膀胱肿瘤，2例为肾细胞癌，1例为输尿管癌。采取了不同的治疗方法。术后中位随访时间为22.5个月。对于同步性肾细胞癌与膀胱肿瘤患者，行部分肾切除术或根治性肾切除术的患者生存率无显著差异。随访期间，3例患者死于肾细胞癌，3例患者死于非肿瘤性疾病，1例患者死于输尿管癌。3年总生存率为82.7%。对于同步性肾细胞癌与膀胱肿瘤患者，行部分肾切除术或根治性肾切除术的患者生存率无显著差异（P=0.874）。肾细胞癌与尿路上皮癌同时发生在临床上较为罕见。治疗应个体化。同步性肾细胞癌与尿路上皮癌患者的预后与侵袭性更强的肿瘤相关。
