Squamous Cell Carcinoma Of The Urinary System:Clinical Analysis

Objective:Squamous cell carcinoma of the urinary system includes squamous cell carcinoma of the upper urinary tract,the bladder,the urethra, etc..Squamous cell carcinoma of the urinary system is a rare tumor of the urinary tract. Analyse and discuss the etiology, epidemiology, clinical features, diagnosis, treatment and prognosis of the squamous cell carcinoma in urinary system, in order to improve the level of awareness and treatment of this disease.Materials and methods:Retrospectively analysed the clinic dates of squamous cell carcinoma of the urinary system who were treated in the first affiliated hospital of guangxi medical university between January 2003 and March 2016. Summarized the clinical characteristics,diagnosis,treatment, prognosis,and combined with literatures to analyze and discuss.Results:In 35 cases of squamous cell carcinoma of the urinary system,30 males,5 females,age 31 to 78 years,average age was 58.2±10.9 years,19 cases were primary squamous cell carcinoma of the bladder,14 cases were squamous cell carcinoma of the kidney,2 cases were squamous cell carcinoma of the ureter. In clinical features, squamous cell carcinoma of the urinary system often had urinary tract stones,urinary tract infection,also included hematuria, lumbago, hypogastralgia, irritative symptoms of bladder, dysuria, hydronephrosis and (or) pyonephrosis, renal insufficiency etc..35 patients all underwent surgical treatment, including radical nephrectomy, radical nephroureterectomy for renal pelvic carcinoma,partial cystectomy,radical cystectomy and urinary diversion, transurethral resection of bladder tumor, palliative chtaneous ureterostomy. The majority of patients were in T2 stage or above,G2 and G3 grade, according to The TNM staging and the WHO grading. Follow up period from 2 to 85 months, the survival time decreased year by year. The five-year survival rates for squamous cell carcinoma of the bladder, squamous cell carcinoma of the kidney and ureter, squamous cell carcinoma of the urinary system were 11.8%,7.7%,10%.Conclusions:(1) Squamous cell carcinoma of the urinary system is rare in clinical,which relatively common in the age of 50 and above,males, long-term living in rural areas and other weak health conditions. (2) Patients with squamous cell carcinoma of the urinary system often had a history of urinary tract stones and(or) urinary tract infection. Especially the long-term renal calculi complicated with hydronephrosis or pyonephrosis could induce the renal squamous cell carcinoma.(3)A part of patients with the renal squamous cell carcinoma were lack of typically clinical manifestation,often overlaping with the renal calculi complicated with hydronephrosis or pyonephrosis,and the imaging examination did not suggest typical renal space occupying lesions. So early diagnosis of squamous cell carcinoma of the kidney was not relatively easy,which could be missed diagnosis, awareness and prejudgment should be improved before operation.(4)Squamous cell carcinoma of the urinary system was highly malignant, more infiltration,rapid growth, early metastasis, poor prognosis. The degree of malignancy of patients with squamous cell carcinoma of the kidney and ureter was higher than that in patients with squamous cell carcinoma of the bladder. The average survival time of patients with squamous cell carcinoma of the bladder was longer than that of the renal and ureteral squamous cell carcinoma. (5) Factors influencing the prognosis of squamous cell carcinoma of the urinary system were N staging, degrees of tumor differentiation, and surgical methods. Patients with no lymph node metastasis, middle-high differentiation and radical surgery had a relatively longer average survival time. (6) The difference between T staging and survival time was not statistically significant for squamous cell carcinoma of the urinary system,suggesting that the prognosis of the patients who got radical resection operation was relatively better, even though the tumor T stageing was relatively late. For the non radical treatment of T2 stage cancers, doctors must strictly master the indications and also with postoperative adjuvant therapy when necessary, close observation, and so on.