Kidney stones and the risk of renal cell carcinoma and upper tract urothelial carcinoma: the Netherlands Cohort Study

Abstract Background & aims: In recent years, the controlling nutritional status (CONUT) score has increasingly became an effective indicator associated with tumor prognosis. This study was conducted to synthesise data on the prognostic value of CONUT score on patients with upper tract urothelial carcinoma (UTUC) or renal cell carcinoma (RCC) undergoing nephrectomy. Methods: We designed and performed a systematic analysis of studies that verified the correlation between preoperative CONUT score and prognosis for UTUC and RCC using PubMed, Web of Science and Embase. The conclusion was clarified by pooled hazard ratios (HR) and 95% confidence intervals (95% CI). Subgroup analysis were further conducted in accordance with different primary tumor. Results: Six studies involving 3529 patients were included in this evidence synthesis, which revealed that the CONUT score had a potential role to predict the survival of UTUC and RCC patients accepting surgery. Pooled analysis showed that the overall survival (OS, HR 2.32, p<0.0001), cancer-special survival (CSS, HR 2.68, p<0.0001) and disease-free survival (DFS, HR 1.62, p<0.00001) were inferior in the high CONUT score group when compared with low score group. Subgroup analysis revealed that this result was in line with UTUC (OS: HR 1.86, P=0.02; CSS: HR 2.24, P=0.01; DFS: HR 1.54, P<0.00001) and RCC (OS: HR 3.05, P<0.00001; CSS: HR 3.47, P<0.00001; DFS: HR 2.21, P=0.0005) patients respectively. Conclusion: The CONUT score is a valuable preoperative index to predict the survival of patients with UTUC or RCC undergoing nephrectomy.

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Two Different Upper Tract Urological Malignancies on Either Side

Case Reports in Urology ◽

10.1155/2021/9981381 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

W. S. L. De Silva ◽

S. R. De Almeida ◽

G. D. B. J. Karunarathne ◽

A. A. S. Samarathunga ◽

K. M. C. S. Gannoruwa ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Urothelial Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Renal Mass ◽

Transitional Cell ◽

Upper Tract Urothelial Carcinoma ◽

Malignant Neoplasms ◽

Upper Tract ◽

The Right

Introduction. The genitourinary system is a recognized site for multiple primary malignant neoplasms even without syndromic anomalies. However, to the best of our knowledge, a case of upper tract urothelial carcinoma (UTUC) with contralateral renal cell carcinoma (RCC) is not reported in surgical literature so far. Case Presentation. A 52-year-old Sri Lankan male patient was found to have a right lower ureteric tumour and a left renal mass together upon investigating for painless visible hematuria. The right ureteric tumour measured 32 × 22 mm resulting in moderate hydronephrosis and cortical thinning of the right kidney, and the left renal mass measured 43 × 38 mm involving the lower pole. The biopsy of the right ureteric lesion revealed a high-grade transitional cell carcinoma with focal nested pattern and that of the left renal mass revealed a clear cell carcinoma. Right nephroureterectomy followed by a left partial nephrectomy was performed in six weeks’ interval. The histology of both the resected specimens confirmed the biopsy findings. Discussion. A high-risk upper tract urothelial carcinoma such as the right ureteric tumour of this patient required a nephroureterectomy which makes the management of the contralateral renal cell carcinoma more complex. An adequate functional renal remnant was ensured after offering oncologically sound surgical treatment for both the malignancies of this patient. Conclusion. A UTUC when associated with a contralateral RCC poses challenges in patient management. The preservation of renal excretory function has to be considered as an important determinant in addition to oncologically sound surgical resection when managing complex cases of genitourinary malignancies involving both sides of the upper urinary tract.

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