Natürlicher Verlauf des Marburger Patientenguts an operierten Plattenepithelkarzinomen des Harntrakts

"Natural history of surgically treated squamous cell carcinoma of the urinary tract in Marburg" Introduction: Squamous cell carcinoma and transitional cell carcinoma with squamous differentiation are a rare entity in western countries. Their therapy is attached to treatment modalities of common transitional carcinoma. It was the aim of our study, to characterize tumor biology, prognosis and therapy of SCC, regarding the current treatment modalities of urinary tract cancer. Material and methods: We performed a retrospective analysis of 53 patients with SCC and TCC with squamous differentiation treated at the urological university hospital in Marburg from 30.05.1989 - 30.09.2004. Tumorstaging, therapy and survival were systematically analysed. Results: Squamous cell carcinoma was found in 2% (42/1573) of bladder carcinoma and 7% (11/130) of renal pelvis specimen. Regarding the TNM-stage, 50% of our patients presented with pT3, indicating a tendency to deep muscular invasion. 60% of the reviewed cases were graded G3. Nodal and distant metastases were rare with only 26%. The overall 5-year survival rate amounts 26% (tumorspecific 46%), with a median survival of 11.13 months. 3 of 4 patients with pT2N0 bladder carcinoma could be cured by radical cystectomy. For carcinoma localised in the renal pelvis, median survival was 7.35 months, with an overall 5-year-survival of 30%. T-stage and lymphonodal status were identified as prognostic parameters regarding survival. Adjuvant therapy modalities were only performed in a minority of cases, although a therpeutic response was often noticed. Conclusions: Squamous cell carcinoma and transitional cell carcinoma with squamous differentiation show a worse prognosis and an individual tumorbiology in comparison to pure TCC. Survival is closely connected to local tumor extension, indicating the necessity of an early radical surgery. In analogy to the treatment of pure transitional carcinoma, adjuvant radio-/chemotherapy can be a therapeutic option.