Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China.
Breast Disease Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
Front Public Health. 2022 Oct 31;10:994351. doi: 10.3389/fpubh.2022.994351. eCollection 2022.
To better understand the characteristics, and survival outcomes of synchronous renal cell carcinoma (RCC) and urothelial carcinoma (UC), we described and analyzed the clinical features, factors, and prognosis of patients with synchronous RCC and UC using a large population-based database.
Within the Surveillance, Epidemiology, and End Results (SEER) database (2004-2016), we identified patient with concurrent RCC and UC at initial diagnosis. Their clinicopathological features and prognosis were evaluated. A logistic regression model was used to examine risk factors for the occurrence of concomitant RCC and UC, and Kaplan-Meier survival curves were used to estimate overall survival.
A total of 61,454 RCC patients were identified from the SEER database, 704 (1.1%) patients presented with synchronous RCC and UC. Among these patients, concurrent bladder tumors (566/704) are more common. Subsequently, subgroup analysis based on the location of UC indicated that patients with concurrent RCC and upper tract urothelial carcinoma (UTUC) had unfavorable UC characteristics (higher tumor stage and grade), compared with patients with concomitant bladder cancer. An increased risk of concurrent UC was observed among older age, male sex, and white race. Meanwhile, papillary RCC histology [odds ratio (OR) 3.23; 95% confidence interval (CI) 2.13-4.90], and smaller tumor (OR 6.63; 95% CI 4.46-9.87) were independent risk factors for concomitant UTUC. In addition, we found that synchronous RCC and UTUC was associated with worse survival by using Kaplan-Meier and multivariable analysis [hazard ratio (HR) 2.36, 95% CI 1.89-2.95]. However, concomitant bladder cancer did not affect survival outcomes of patients with RCC (HR 1.00, 95% CI 0.86-1.17).
We found that synchronous concurrent RCC and UC is relatively uncommon and mostly located in the bladder. Older age, male sex, and white race increase the risk of synchronous RCC and UC. Meanwhile, patients with papillary RCC histology, and smaller tumors are more likely to have concomitant RCC and UTUC. Furthermore, our findings suggest that synchronous RCC and UTUC has a worse prognosis, while, concomitant bladder tumor did not affect the oncological outcomes of RCC.
为了更好地了解同步肾细胞癌（RCC）和尿路上皮癌（UC）的特征和生存结果，我们使用大型基于人群的数据库描述和分析了同步 RCC 和 UC 患者的临床特征、因素和预后。
在监测、流行病学和最终结果（SEER）数据库（2004-2016 年）中，我们在初始诊断时确定了同时患有 RCC 和 UC 的患者。评估了他们的临床病理特征和预后。使用逻辑回归模型检查发生同时性 RCC 和 UC 的危险因素，并使用 Kaplan-Meier 生存曲线估计总生存。
从 SEER 数据库中确定了 61454 例 RCC 患者，其中 704 例（1.1%）患者同时患有 RCC 和 UC。在这些患者中，同时存在膀胱肿瘤（566/704）更为常见。随后，根据 UC 的位置进行亚组分析表明，与同时患有膀胱癌的患者相比，同时患有 RCC 和上尿路尿路上皮癌（UTUC）的患者具有不利的 UC 特征（更高的肿瘤分期和分级）。年龄较大、男性和白种人患同时性 UC 的风险增加。同时，乳头状 RCC 组织学[优势比（OR）3.23；95%置信区间（CI）2.13-4.90]和较小的肿瘤（OR 6.63；95%CI 4.46-9.87）是同时发生 UTUC 的独立危险因素。此外，我们通过 Kaplan-Meier 和多变量分析发现，同时性 RCC 和 UTUC 与较差的生存相关[危险比（HR）2.36，95%CI 1.89-2.95]。然而，同时性膀胱癌并不影响 RCC 患者的生存结果[HR 1.00，95%CI 0.86-1.17]。
我们发现同步性同时性 RCC 和 UC 相对少见，主要位于膀胱。年龄较大、男性和白种人增加了同时性 RCC 和 UC 的风险。同时，具有乳头状 RCC 组织学和较小肿瘤的患者更有可能同时发生 RCC 和 UTUC。此外，我们的研究结果表明，同时性 RCC 和 UTUC 的预后较差，而同时性膀胱肿瘤并不影响 RCC 的肿瘤学结果。
