Clinical Analysis Of 11 Cases Of Renal Pelvic Transitional Cell Carcinoma With Venous Tumor Thrombus

ObjectiveTo investigate the clmical features,imaging misdiagnosis reasons,treatment,pathological features,prognosis of renal pelvic transitional cell carcinoma with venous tumor thrombus,to improve the understanding of such rare cases.MethodsThe clinical data and follow-up data of 11 cases of renal pelvic transitional carcinoma with venous tumor thrombus diagnosed by surgical pathology or puncture pathology from September 2009 to September 2018 were retrospectively analyzed.COX regression model was used to analyze the factors affecting the prognosis of renal cell transitional cell carcinoma with venous tumor thrombus.ResultsThe average age of onset in 11 patients in this study was 66.2±7.0 years,and the male to female ratio was 4.5:1.The most common symptoms are lumbar and abdominal pain,followed by gross hematuria and anorexia.Of the 11 cases,9 were renal vein thrombosis,and 2 were inferior vena cava tumor thrombus and renal vein tumor thrombus.6 cases were misdiagnosed as renal cell carcinoma in imaging,5 cases were diagnosed as renal pelvic cancer,and the average length of the tumor in the misdiagnosed group was(9.9±2.3cm).The average length of the tumor in the correct diagnosis group was(4.7±0.5cm),there was a significant difference in the longest diameter of the two groups(P<0.05).11 cases of high-grade invasive urothelial carcinoma were reported by surgery or puncture pathology.The median survival time of 11 patients was 4 months.COX regression model analysis showed that systemic chemotherapy(P=0.046)was the main factor affecting the prognosis of renal pelvic transitional cell carcinoma with venous thrombosis.ConclusionRenal pelvic transitional cell carcinoma with venous tumor thrombus is extremely rare.The first symptom is mainly lumbar or abdominal pain,but it is not typical.It is difficult to distinguish with renal cell carcinoma by imaging.Such eases are pathologically malignant and have a poor prognosis.Systemic chemotherapy may improve the prognosis of patients,but the impact of surgery on prognosis is not clear and requires more studies.