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

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.

[Clinical significance of residual tumors at repeat transurethral resection in patients with T1 bladder cancer].

OBJECTIVE: To investigate the predictors of residual tumors at repeat transurethral resection of bladder tumors (re-TURBT) for the patients with T1 bladder cancer and evaluate the effect of the residual tumors on the prognosis of the disease. METHODS: We reviewed the clinical data of the patients with T1 bladder cancer who underwent re-TURBT from 2008 to 2015 in our department. Seventy-two patients received re-TURBT 2-6 weeks after the initial TURBT. A total of 65 patients were followed up, and we recorded the events of tumor recurrence, tumor progression, radical cystectomy and cancer specific death.The influencing factors of re-TURBT positive rate were analyzed.The effects of re-TURBT positive or negative findings on the prognosiswere compared. RESULTS: 33.3% of the patients who received re-TURBT had residual tumours. Re-TURBT positive in T1 bladder cancer has significant correlation with tumor size (P<0.05). Residual tumors tended to be detected in patients with larger tumors (diameter ≥ 4 cm) but might have no relationship with tumor grade or tumor number. The recurrence rate within 3 month ofthe patients with residual tumours at re-TURBT was 25% (5/20), while there were no patients suffering recurrence who had no residual tumours at re-TURBT, which had a significant difference (P<0.001). However, the overall recurrence rate, progression rate, rate of radical cystectomy and cancer specific mortality showed no significant difference between the two groups (45% vs 40%, P=0.71; 10% vs 6.7%, P=0.64; 5% vs 8.9%, P=0.59; 5% vs 2.2%, P=0.55). CONCLUSIONS: For the patients with T1 bladder cancer, larger tumors could be a predictor for residual tumors at re-TURBT. The presence of residual tumors is associated with early recurrence.