Concurrent renal cell carcinoma and urothelial carcinoma: long-term follow-up study of 24 cases

Abstract

Objective: To investigate the clinical manifestation, diagnosis, treatment and outcome of simultaneous occurrence of renal cell carcinoma and urothelial carcinoma. Methods: 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. Results: 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 (P=0.874). Conclusions: 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.