多层螺旋CT三维成像在原发性输尿管癌诊断中的应用价值

目的探讨多层螺旋CT三维成像技术（3D—MSCT）在原发性输尿管癌诊断中的应用价值。方法对14例无痛性肉眼血尿，经静脉尿路造影（IVU）、B超、膀胱镜等检查除外肾、膀胱肿瘤，疑为输尿管占位性病变的患者，选用3D—MSCT检查，结果与手术病理结果进行比较。结果3D—MSCT发现输尿管占位性病变13例，曲面重建图像表现为输尿管腔内软组织影，约0．5cm×0．5cm～3．0cm×4．5cm，管腔内充盈缺损，管腔偏纵轴狭窄，输尿管上段及肾盂不同程度扩张。影像学诊断：原发性输尿管癌10例，输尿管良性息肉3例，另1例为输尿管子宫内膜异位症。术后病理检查结果与3D—MSCT诊断结果完全一致。结论3D—MSCT可直观输尿管腔内占位性病变，在某种程度上可以替代IVU，对诊断原发性输尿管肿瘤有重要价值。     

肾盂粘液腺癌1例报告

患者，男，74岁。因左肾结石10余年，发现左腹部肿物进行性增大伴尿频、粘液尿3年入院。KUB及IVU检查见右侧第2～4腰椎横突旁有一鹿角状结石影，约6．5cm×4．5cm×2．0cm，左肾30min不显影。逆行肾益造影见左肾盂及输尿管向右侧移位，肾孟呈球形扩张，肾盏消失，有不规则充盈缺损，肾盂内一鹿角状结石影同KUB检查所见。膀胱镜检查未见肿瘤，但左侧输尿管口有粘液状物流出，粘液染色阳性，未行居细胞学检查。入院诊断为左肾盂粘液腺癌。因患者高龄，体质较差，仅行左肾及输尿管上殷切除术。术后恢复顺利。病理检查见左肾约25cm×20cm×1…     

右侧完全性重复肾畸形伴同侧输尿管癌及输尿管结石一例报告

患者,女,77岁.主因间断全程无痛性肉眼血尿3个月于2011年4月26日入院.无尿频、尿急、尿痛,无腰痛、发热.查体无明显阳性体征.超声检查:右侧肾窦回声分离4.2cm,右肾窦中部可见分隔;上位肾延续出管状结构,其输尿管末端可见多发强光团,最大直径1.3 cm;下位肾输尿管扩张至膀胱,扩张的输尿管末端管腔内可见5.7 cm×3.0 cm低回声影.CT检查:右肾形态明显增大,右侧肾盂、肾盏、输尿管扩张积水,肾实质明显受压变薄,右输尿管下段可见软组织样密度影,边界较清晰,密度较均匀,中段沿管壁可见高密度影,末端可见条状高密度影并突入膀胱;增强扫描示右输尿管下段病变有强化,边界清晰,密度均匀;延时扫描未见右肾盂、肾盏内造影剂充盈.MR检查:右肾形态明显增大,可见重复集合系统;下位肾盂、肾盏、输尿管明显扩张,下位输尿管下段可见充盈缺损;上位肾盂、肾盏显影不良,输尿管扩张,其下段部分输尿管未见显影.IVU检查:右肾明显增大,部分肾盏显示隐约扩张,右肾盂及输尿管未见显影.肾动态显像检查:左侧肾小球滤过率65.82 ml/min,右侧1.01 ml/min.     

双肾盂双输尿管及膀胱癌1例报告

患者，女，63岁。3月前无明显诱因出现无痛性全程肉眼血尿，间歇性发作伴尿频，白天排尿为5～6次，夜间3～4次。体检无阳性体征。B超检查膀眈右侧壁探及一1．6cmX0．8cm凸向腔内的菜花样稍强回声团，基底宽，双肾未见异常，拟诊为膀优癌。膀优镜检查示膀脱右侧壁有一2．5cmX2．0cm菜花样肿物，有蒂，双输尿管口清晰，无喷血，诊断为膀脱癌。IVU及逆行输尿管肾益造影示双肾下极不规则充盈缺损，右侧为5．0cmX2．0cm，左侧为3．0cmXI·5cm；双输尿管下方近膀脱开口处分别见卵圆形充盈缺损，膀航右侧壁亦示一小充盈缺损。诊断：双肾孟癌、…     

肾楔形切除术治疗肾上盏移行细胞癌1例

患者 ,男 ,55岁。因无痛性肉眼血尿 50 d于1 999年 7月 2日入院。以往有膀胱切开取石史。体检无异常发现。尿常规 :红细胞 (++++) ,蛋白(++)。尿细胞学检查 2次 ,见可疑癌细胞 1次。肝、肾功能正常 ,血糖 8.68mmol/L。 IVU示右肾轮廓约为正常的 1 /2 ,肾盂肾盏显示不清 ,左侧肾盂及输尿管显影良好 ,但肾小盏杯口不清。逆行尿路造影显示 :左肾上盏充盈缺损影直径约 2 .0 cm,右肾盂及输尿管显影正常 ,肾小盏扩张积水。CT强化薄扫显示 :右肾体积明显缩小 ,皮质变薄 ,肾盏扩大 ,左肾体积增大 ,左肾上盏内有一类圆形软组织密度影 ,直径约 2 .5…     

肾间质血管畸形一例报告

患者，女，38岁。因反复血尿15年入院。血尿为全程肉眼血尿，伴有血凝块。B超示右肾大小正常，实质回声增强，集合系统分离暗区约1．5cm，左肾未见异常。IVU示右肾盏及右输尿管上段连接部管腔较狭窄。膀胱镜检查可见右输尿管口喷血，膀胱内未见异常。右侧输尿管逆行插管造影示输尿管近输尿管开口处呈杯口状充盈缺损。CT示右肾体积增大，右肾中极内份低密度影，     

输尿管占位性病变的多层螺旋CT鉴别诊断

目的 探讨多层螺旋CT在输尿管占位性病变鉴别诊断中的应用价值。资料 回顾性分析经病理证实的16例输尿管癌、4例输尿管子宫内膜异位和3例输尿管息肉的CT资料。结果 16例输尿管癌的CT表现为管壁增厚3例、腔内充盈缺损7例和腔外肿块6例,合并后腹膜淋巴结肿大5例。4例输尿管子宫内膜异位者CT表现为腔外软组织肿块3例、腔内充盈缺损1例,合并附件囊性灶2例。3例输尿管息肉均表现为腔内充盈缺损。结论 MSCT在鉴别输尿管占位性病变方面具有很高的临床应用价值。     

肾盂癌肉瘤1例报告及文献复习

目的：探讨肾盂癌肉瘤的组织学特点、临床表现、治疗和预后。方法：肾盂癌肉瘤患者1例,患者女性,73岁,因右侧腰腹部疼痛1个月,加重伴肉眼血尿1天入院。既往史：12年前行左侧乳腺癌改良根治术,11年前因乳腺增生行右侧乳腺切除术,10年前行子宫肿瘤切除术。查体：无专科阳性体征。辅助检查：泌尿系彩超见：右肾下部实质内可见一实质性低回声,大小为5．7cm×5．6cm,边界欠清晰,内部回声不均匀。肾脏CT三期增强：右肾体积略大,形态尚规整,右肾肾盂内见片状高密度影,大小约2．4cm×2．5cm,CT值约57HU,增强扫描略强化,右肾实质内见片状低密度影,增强扫描未见强化,右侧肾盂扩张,右侧肾前筋膜、肾周筋膜略增厚。所示层面右侧输尿管上段略扩张,管腔密度增高,CT值约48HU,增强扫描略强化。腹主动脉与右肾静脉间见多个结节样软组织密度影,大小约0．4～1．0cm,增强扫描强化。逆行泌尿系造影提示：对比剂至L3～4水平截断,其上方输尿管及肾盂未见显示。尿脱落细胞学：1次找到可疑癌细胞。术前临床诊断：右肾盂癌（Ts期）。结果：全麻下行后腹腔镜右肾根治性切除术、开放输尿管切除术。术中见：肾脏上极腹侧面的肾实质上可见一长约6cm×5cm灰白色占位性病变,与周围界限不清。病理回报：右肾盂癌肉瘤。术后随访8个月未见肿瘤复发及远处转移。结论：肾盂癌肉瘤罕见,恶性程度高,预后差。病理诊断需与肉瘤样癌鉴别。早期诊断和积极的手术切除是延长患者生存的最有效方法。     

肾盏造瘘技术在小婴儿重度肾积水腹腔镜肾盂成形术中的应用

目的探讨小婴儿重度肾积水行腹腔镜肾盂成形术中输尿管双J管置入失败,应用肾盏造瘘替代输尿管双J管引流的效果。方法 2016年4月～2017年6月6例小婴儿重度肾积水肾盂成形术中放置输尿管双J管失败,经肾盏留置吻合口支架管和肾盂造瘘管,替代输尿管双J管的引流作用。术后2～3周拔除吻合口支架管,夹闭肾盂造瘘管行亚甲蓝排泄试验阴性后拔除肾盂造瘘管。结果 6例患儿术中行肾盏造瘘,顺利留置吻合口支架管和肾盂造瘘管,术后肾盂造瘘管引流通畅。拔除吻合口支架管,夹闭肾盂造瘘管和拔管后患儿均无发热、呕吐及哭闹不适。4例术后1、3、6、12个月随访,超声或CT示肾积水明显减轻(肾盂前后径1 cm,肾盏扩张0. 5 cm),肾皮质逐渐增厚至0. 5～1. 0 cm(术前肾皮质最薄处仅1mm),肾脏形态接近正常; 2例患儿术后6个月复查肾核素扫描示分肾功能接近正常,分别为47. 3%、48. 2%(分肾功能50%为正常)。结论肾盏造瘘技术在小婴儿重度肾积水腹腔镜肾盂成形术中的辅助作用确切,效果良好。     

小儿离断性肾盂成形术中同心双腔管的应用

目的总结小儿肾盂输尿管连接部梗阻（UPJO）的诊治经验。方法回顾分析56例小儿肾盂输尿管连接部梗阻患儿的临床资料，其中肾盂输尿管连接部狭窄42例．肾盂输尿管高位连接4例。迷走血管压迫7例，纤维条索压迫3例，行Anderson-Hynes离断性肾盂成形并同心双腔管肾造瘘45例，输尿管-肾下盏吻合并同心双腔管肾造瘘4例，单纯纤维条索松解术3例，肾切除4例。结果18例随访5—72个月，其中1例松解术后患者肾积水加重，其余病人肾积水明显减轻。结论Anderson Hynes肾盂成形并同心双腔管肾造瘘术是治疗UPJO的理想方式。     

上尿路罕见肿瘤2例报告及文献复习

目的：探讨上尿路罕见肿瘤的诊治和预后。方法：回顾性分析2007年2月和12月收治的同时同侧肾及肾盂透明细胞癌和原发输尿管鳞状细胞癌患者各1例的临床资料,并结合文献进行总结。结果：2例患者术前未能明确诊断,实施了探查性手术,成功切除肿瘤,术后至今无复发或转移。结论：同时同侧‘肾及肾盂透明细胞癌和原发输尿管鳞状细胞癌均属罕见病例,但有其特点,可通过病史、辅助检查等初步与移行细胞癌等常见肿瘤相鉴别,从而选择恰当的治疗方式。预后有待进一步随访。     

A case of synchronous ipsilateral renal cell carcinoma and transitional cell carcinoma]

A case of synchronous ipsilateral renal cell carcinoma with renal pelvic and ureteral transitional cell carcinoma is reported. A 80-year-old man, who had had transurethral resection of bladder tumor three times, was admitted on August, 1989 for recurrence of bladder tumor. Excretory pyelography revealed a filling defect of left renal pelvis. Findings of retrograde pyelography and computed tomography were in accord with those of the excretory urograms. Under a diagnosis of the left renal pelvic and ureteral tumor associated with the bladder tumor, left nephroureterectomy with bladder cuff resection was performed. Pathological diagnosis was renal pelvic and ureteral transitional cell carcinoma with renal cell carcinoma, which existed incidentally in the same kidney. Double unrelated primary carcinoma in urinary tract, especially, double dissimilar primary carcinoma in the same kidney, is rare. To our knowledge, this case is the 20th double cancer in upper urinary tract reported in Japan.     

内镜下钬激光治疗早期上尿路上皮肿瘤特殊病例1O例报告

目的探讨内镜下钬激光治疗特殊早期上尿路上皮肿瘤的安全性及有效性。方法2002年4月～2010年5月,对10例不适合行根治性。肾输尿管切除术的早期上尿路上皮肿瘤患者行内镜下钬激光治疗,其中输尿管肿瘤7例（1例合并膀胱肿瘤）,肾盂肿瘤3例。单发7例,多发3例。术前肿瘤分期cTa～cT1。3例对侧已行肾输尿管全长切除,2例孤立肾,3例肾功能不全,1例2～3级心功能不全,1例肿瘤小（〈1cm,位于。肾盂,单发且表浅）。输尿管硬镜治疗7例,软镜1例,微通道经皮肾镜2例。术后行丝裂霉素上尿路及膀胱灌注化疗。结果10例术后随访2年,无肿瘤死亡。1例术后6个月输尿管狭窄,其余均未出现大出血、严重感染、周围脏器损伤及全身肿瘤转移。复发4例,其中1例输尿管合并膀胱肿瘤者膀胱内复发,1例为肾盂内单发肿瘤复发,2例为输尿管单发肿瘤复发。该4例随访5年,1例未见肿瘤复发与转移,3例复发3—4次,且为尿路多处复发,行肾盂输尿管癌根治术,其中2例术后血液透析1年内肿瘤转移死亡。结论对不适合行根治性肾输尿管切除术的早期上尿路上皮肿瘤,内镜下钬激光治疗短期内是安全有效的。     

经皮肾镜技术治疗上尿路肿瘤的初步经验

目的 评价经皮肾镜技术在上尿路肿瘤中的应用效果.方法 2006年6月至2010年6月经皮肾镜治疗上尿路肿瘤患者8例(10侧).男6例(7侧),女2例(3侧).年龄52～72岁,平均61岁.孤立肾4例,慢性肾功能不全2例,双侧肾盂肿瘤2例.高级别肿瘤4侧,低级别肿瘤6侧.肿瘤直径0.5～3.5 cm,平均2.6 cm.患者均接受经皮肾镜激光或电刀肿瘤切除术,术中留置输尿管支架管,术后经肾造瘘管灌注化疗药物.结果 8例手术均获成功,手术时间45～95 min,平均73 min;术中出血量20～300 ml,平均50 ml,术后SCr水平较术前下降或无明显变化.随访10～36个月,采用CT、MRI及输尿管镜检观察肿瘤复发情况.1例死于肿瘤转移,2例肿瘤局部复发.余5例未见肿瘤复发.结论 经皮肾镜技术治疗上尿路肿瘤安全可行,手术效果良好,对不宜行肾输尿管切除术的上尿路肿瘤患者来说是一种良好的选择.

Abstract：

Objective To evaluate the application of percutaneous nephroscopy in the treatment of upper urinary tract transitional cell carcinoma, particularly renal pelvic carcinoma. Methods From June 2006 to June 2010, eight cases (with 10 sides) of renal pelvic carcinoma received percutaneous nephroscopy tumor resection. There were six males (with 7 sides) and two females (with 3 sides) in the study group. There were six cases with solitary kidney and two cases with bilateral renal pelvic tumors. There were four cases with high-grade tumors and six cases with low-grade tumors. The age of patients ranged from 52 to 72 yrs (average 61.2 yrs). Tumor sizes ranged from 0.5 to 3.5 cm (average 2.6 cm). Patients were treated with laser or electrocautery through percutaneous nephroscopy. A ureteral stent was placed in the patients after the procedure. Chemotherapy was administered postoperatively through the nephrostomy tube. Results All the operations were successfully completed uneventfully. The operative time was 45-95 min (average 73 min), estimated blood loss was 20-300 ml (average 50 ml). No remarkable differences were found in serum creatinine levels before and after operation. After 10 to 36 mon. follow-up by CT, MRI, and ureteroscopy, one patient died of tumor metastasis and two patients had local tumor recurrence. The remaining patients had no local recurrence. Conclusions Percutaneous nephroscopy in treating renal pelvic tumor is safe and feasible. This is a better choice for the renal pelvic carcinoma patients who are unsuitable for ureteronephrectomy.     

输尿管镜结合钬激光技术治疗孤立肾上尿路尿路上皮癌3例报告

目的总结输尿管镜结合钬激光技术治疗孤立肾上尿路尿路上皮癌的诊治体会。方法回顾性分析3例孤立肾上尿路尿路上皮癌患者的临床资料和随访结果。3例均为女性,1例输尿管癌,其对侧肾萎缩无功能;1例肾盂癌,曾因对侧输尿管癌接受肾输尿管全长切除术;1例为移植肾肾盂癌。3例患者均接受输尿管镜钬激光治疗。结果术后平均随访2年,3例患者均存活,其中1例无复发,1例因对侧萎缩肾一侧发生输尿管癌而再次接受输尿管镜钬激光治疗,术后无复发,1例因移植肾肾盂癌伴膀胱癌复发接受肾输尿管及膀胱切除术。结论对于解剖性或功能性孤立肾上尿路尿路上皮癌,输尿管镜结合钬激光技术是一种可选择方法,但术后应密切随访。     

Nonoperative diagnosis of pyelocalyceal deformity due to venous impressions.

Two patients with filling defects on films of the upper urinary tract caused by venous impressions are reported. To date, the literature includes 22 other cases. These cases are frequently associated with hematuria, flank or abdominal pain; the filling defect might be found incidentally during the evaluation of another problem. The two most frequent causes are varices--of renal vein, renal pelvic vein, ureteral veins, and normal renal vessels. Generally, the lesions were not diagnosed without surgical intervention. The filling defects of our cases were caused by other types of lesions. Their diagnosis was made nonoperatively through the use of intravenous pyelography, renal arteriography, and retrograde phlebography. Filling defects caused by venous impressions on the upper urinary tract should be diagnosed by the use of these three studies rather than surgically.     

Completeness and correctness of registration of renal pelvic and ureteral cancer in the Swedish Cancer Registry

OBJECTIVE: To study the completeness and correctness of the Swedish Cancer Registry (SCR) for renal pelvic and ureteral carcinomas diagnosed in western Sweden. MATERIAL AND METHODS: We performed a retrospective clinical and histopathological study of 939 patients in the SCR with a diagnosis of a renal pelvic or ureteral carcinoma between 1971 and 1998 and of 54 patients with a diagnosis of tumors in multiple locations in the urinary tract. In addition, we reviewed our earlier bladder cancer studies to assess whether patients with upper urinary tract tumors had been notified to the SCR. RESULTS: There were 68 false-positive patients (7.2%) out of 939 in the SCR. The commonest diagnoses were other urological malignancies (n=46) and no malignancy at all (n=15). There were five false-positives (9.3%) out of 54 patients in the file with tumors in multiple locations. Twenty-eight patients with renal pelvic or ureteral carcinoma were identified in our earlier studies but not found in the SCR. Most discrepancies were attributable to inadequate or missing notification by the urologist and registration errors. CONCLUSIONS: The completeness and correctness of the registration of renal pelvic and ureteral carcinomas are unsatisfactory but in line with registries for some other primary sites. The notification of upper urinary tract tumors among patients with a history of bladder cancer was poor, in particular in patients not treated with surgery. Improved communication between reporting sources and the registry is needed. Clinical and histopathological reviews seem necessary in studies based on the SCR.     

肾移植术后并发双侧自体肾盂和输尿管移行细胞癌16例

目的 总结肾移植术后发生双侧自体肾盂、输尿管移行细胞癌的诊治经验.方法 回顾性分析16例肾移植术后发生双侧自体肾盂、输尿管移行细胞癌患者的资料.首次发现上尿路肿瘤的时间为移植后(56.2±33.0)个月.2例同时发现双侧上尿路肿瘤,其余14例双侧上尿路肿瘤先后发现的时间间隔为(8.6±6.7)个月.临床症状和检查阳性结果以血尿和自体肾积水为主.均行自体上尿路根治性切除术,术后行膀胱灌注化疗.结果 16例手术均成功.32次自体肾、输尿管的病理检查结果均为移行细胞癌,包括单纯肾盂肿瘤4次,单纯输尿管肿瘤9次,合并肾盂、输尿管肿瘤19次.23次肾盂肿瘤的分级为1级8例,2级11例,3级4例;28次输尿管肿瘤的分级为1级6例,2级10例,3级12例.术后随访(26.8±25.1)个月,1例出现肺部转移后死亡;1例发生腰背部软组织转移性移行细胞癌,局部切除;其他患者未发现肿瘤复发及转移.结论 肾移植后自体上尿路移行细胞癌的常见表现为血尿合并自体肾积水,该肿瘤侵袭性较强,对于膀胱及一侧自体上尿路同时存在移行细胞癌者,应行对侧自体肾上尿路预防性切除术.

Abstract：

Objective To investigate the clinical features of bilateral native pelvic and ureteral transitional cell carcinoma (TCC) in renal transplant patients. Methods A retrospective analysis was carried out on 16 patients with bilateral native pelvic and ureteral TCC after kidney transplantation.The mean time between transplantation and diagnosis of upper urinary TCC was 56. 2 ± 33. 0 months.Two patients were suffered from bilateral upper urinary TCC at the same time. The mean interval between 2 upper urinary tract operations of the remaining 14 cases was 8. 6 ± 6. 7 months. Hematuria and hydronephrosis of native kidneys were the main symptoms and targets in checkup. Intravesical chemotherapy was postoperatively given. Results All operations were performed successfully. All specimens obtained from the operations were pathologically diagnosed as TCC. The TCC location involved pure native pelvis (n = 4), pure native ureter (n = 9), and pelvis combined with ureter (n = 19). Pelvic TCC pathological grades included grade 1 in 8 cases, grade 2 in 11 cases, and grade 3 in 4 cases; Ureteral TCC grades included grade 1 in 6 cases, grade 2 in 10 cases, and grade 3 in 12 cases.Patients were followed up for 26. 8 ± 25. 1 months. One patient died of lung metastasis. (One case of lumbar soft tissue transfer was given local excision. The remaining patients had no recurrence and metastasis. Conclusion Renal transplant patients with hematuria and native renal hydronephrosis should be highly vigilant of the occurrence of upper urinary tract TCC. TCC after renal transplantation is invasive. Prophylactic contralateral nephroureterectomy should be performed on the recipients having TCC at the bladder and one side of native upper urinary tract.     

Long-term follow-up of endoscopically treated upper urinary tract transitional cell carcinoma

Objectives

This report focuses on the long-term follow-up of patients with endoscopically treated upper tract transitional cell carcinoma (TCC) to determine the effectiveness of endoscopic therapy.

Methods

From May 1983 to April 1994, 44 patients with TCC of the upper urinary tract underwent conservative endourologic treatment with either electrocautery fulguration or neodymium:yttrium-aluminumgarnet laser at our institution. The mean follow-up period was 5 years (range, 3 months to 11 years).

Results

Renal pelvic tumor sizes ranged from 0.4 to 4.0 cm (mean, 1.5) and ureteral tumors from 0.2 to 1.0 cm (mean, 0.5). The majority of tumors were of pathologic grade 3 or less, and all were Stage T2 or less. Seventeen of 44 patients (38.6%) had local tumor recurrence (mean time to recurrence, 12.8 months; range 1.5 to 64). Mean recurrence time was 7.3 months for renal pelvic tumors and 17.8 months for ureteral tumors. Nineteen of 44 patients (43.2%) developed bladder tumors. The overall 5-year disease-free rate was 57%. No recurrent tumor was shown to have increased in grade, and one recurrent tumor was proved to have progressed in stage. Six patients (14%) ultimately required a nephroureterectomy for recurrence. There were no major complications as a result of endoscopic therapy. Six patients (14%) died of the effects of metastatic TCC, 5 of whom had known muscle invasive bladder TCC.

Conclusions

Endourologic techniques and the conservative treatment of upper urinary tract TCC is an evolving field and can be safely and effectively used as a first-line treatment for upper tract TCC in selected patients.     

Clinical studies on renal pelvic and ureteral tumors

Clinical studies were performed on 35 patients with renal pelvic and/or ureteral cancer treated at Kitano Hospital between 1988 and 1997. They consisted of 17 renal pelvic cancers, 17 ureteral cancers and 1 renal pelvic and ureteral cancer. Twenty-nine patients were males and six were females, and their age ranged from 41 to 82 years old (average: 62.2). Histologically, 34 were transitional cell carcinoma and 1 was adenocarcinoma. Pathological stage of the tumor was pTa in 34.3%, pT1 in 14.3%, pT2 in 11.4%, pT3 in 37.1%, and pT4 in 2.9%, and grade of the tumor G1 in 11.8%, G2 in 58.8% and G3 in 29.4%. Eighteen patients (51%) had or developed bladder cancer, which preceded the diagnosis of cancer of upper urinary tract in 2 cases, coexisted in 4 cases and developed subsequently in 12 cases. The overall cause-specific survival rate was 91.3% at 1 year, 83.8% at 3 years and 79.4% at 5 years. Tumor stage, grade, lymph node metastasis and vascular invasion had impact on survival.