%0 Journal Article
%T [Clinical analysis of 121 cases of urothelial carcinoma accompanied with multiple primary carcinoma].
%A Gu YC
%A Ye JF
%A Cao BS
%A Wang MP
%A Ma LL
%A Ma LW
%J Zhonghua Zhong Liu Za Zhi
%V 41
%N 10
%D Oct 2019 23
%M 31648498
暂无%R 10.3760/cma.j.issn.0253-3766.2019.10.007
%X Objective: To investigate the incidence and clinical characteristics of urothelial carcinoma (UC) accompanied with multiple primary carcinoma (MPC). Methods: The clinical data of 121 UC patients with MPC in Peking University Third Hospital from January 2010 to May 2018 were retrospectly analyzed. Results: UC patients with MPC accounted for 9.74% (121/1 242) of all the UC patients. The ratio of male to female patients was 2.10∶1 in the total MPC patients, but it was 1∶1 in the upper urinary tract MPC subgroup. The MPC patients were more common in elderly people, whose medium age was 68 (32-93) years old. Of all the location (131 person-time) of other tumors besides UC, the digestive system tumors occurred most frequently, accounting for 41.98% (55/131), followed by the urinary and male reproductive system tumors (20.61%, 27/131) and the female reproductive system (12.21%, 16/131). The proportion of the digestive system tumors (47.37%, 9/19) was the highest in the upper urinary tract MPC, with a total number of the other primary cancer of 19 person-time. However, the proportion of the urinary and male reproductive system tumors (37.14%, 13/35) was higher in the synchronous MPC group, with a total number of the other primary cancer of 35 person-time. Some patients had a history of radiotherapy and/or chemotherapy before UC was diagnosed. We also observed 2 cases of genetically confirmed Lynch syndrome. The median overall survival (mOS) of UC patients with MPC was 132 months, and the mOS of patients with UC as the first malignancy (including synchronous MPC and UC as the first malignancy in metachronous MPC) was 120 months. The mOS of the synchronous MPC group was 84 months, which was significantly shorter than 178 months of metachronous MPC group (χ(2) =14.029, P<0.001). Conclusions: The incidence of UC accompanied with MPC is not low, and the most common sites of MPC are the digestive system and reproductive system. Therefore, screening for MPC in UC patients, especially those with personal or family history of tumors, as well as elderly patients, may help early diagnosis and treatment of MPC patients and improve their prognoses.<BR>目的： 探讨尿路上皮癌(UC)合并其他多器官原发癌(MPC)的临床病理特征和预后。 方法： 2010年1月1日至2018年5月1日在北京大学第三医院诊治的UC合并MPC患者121例，通过查阅电子病例系统和电话随访，回顾性分析患者的流行病学特征、临床病理特征和预后。 结果： 合并MPC的UC患者占全部UC患者的9.74%(121/1 242)，男女比例为2.10∶1，在上尿路MPC亚组中男女比例为1∶1。MPC患者更常见于老年人，中位年龄为68岁。合并肿瘤共131例次，常累及器官依次为消化系统[41.98%(55/131)]、泌尿及男性生殖系统[20.61%(27/131)]和女性生殖系统[12.21%(16/131)]。上尿路MPC中，累及消化系统肿瘤比例最高[47.37%(9/19)]；但在同时性MPC组中，累及泌尿及男性生殖系统肿瘤比例最高[占37.14%(13/35)]。部分患者确诊UC前有放化疗史，确诊Lynch综合征2例。合并MPC的UC患者中位生存时间(mOS)为132个月，其中首发UC患者(包括异时性MPC中首发UC和同时性MPC)的mOS为120个月。同时性MPC组患者的mOS为84个月，短于异时性MPC组(178个月， P<0.001)。 结论： UC合并MPC发生率较高，合并消化系统和生殖系统最常见。对于确诊UC的患者，特别是有肿瘤既往史或家族史者以及老年患者，筛查MPC有助于患者的早诊早治和改善预后。.