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目的:提高对同时发生的泌尿男生殖系多原发癌(MPMN)的诊断与治疗水平。方法:回顾性分析20例MPMN患者资料。20例均行手术治疗,其中4例晚期前列腺癌合并浅表性膀胱癌行TURBT+TURP,8例浸润性膀胱癌合并早期前列腺癌行根治性膀胱前列腺全切,4例浸润性膀胱癌合并局部晚期前列腺癌,行膀胱部分切除术+化疗及内分泌治疗。2例肾癌合并晚期前列腺癌均行根治性肾切除+内分泌治疗。1例肾癌伴膀胱癌行肾癌根治+TURBT。1例肾癌合并浸润性膀胱癌行肾癌根治+根治性膀胱全切。结果:病理诊断移行细胞癌18例,前列腺癌18例,肾透明细胞癌3例,乳头状肾癌1例。平均随访36(10～48)个月,12例平均生存23个月,8例无瘤生存。结论:泌尿男生殖系同时性MPMN易漏诊,早发现并采用手术为主的综合治疗可显著提高患者生存期,多瘤共存非预后不良的标志。
OBJECTIVE: To improve the diagnosis and treatment of simultaneous diagnosis of multiple primary cancers of male genitourinary tract (MPMN). Methods: The data of 20 patients with MPMN were retrospectively analyzed. Twenty patients with advanced prostate cancer were treated with TURBT + TURP. Eight patients with invasive bladder cancer combined with early stage prostate cancer underwent radical prostatectomy. Four cases of invasive bladder cancer combined with local Advanced prostate cancer, partial cyst excision + chemotherapy and endocrine therapy. 2 cases of renal cell carcinoma with advanced prostate cancer were treated by radical nephrectomy + endocrine therapy. One case of renal cell carcinoma with bladder cancer underwent radical nephrectomy + TURBT. One case of renal cell carcinoma with invasive bladder cancer underwent radical nephrectomy + radical curative resection. Results: The pathological diagnosis of transitional cell carcinoma in 18 cases, 18 cases of prostate cancer, 3 cases of renal clear cell carcinoma, papillary renal cell carcinoma in 1 case. The average follow-up of 36 (10 ~ 48) months, 12 patients with an average survival of 23 months, 8 patients with tumor-free survival. Conclusions: Simultaneous urinary male MPMN misdiagnosis, early detection and operation-based comprehensive treatment can significantly improve the survival of patients, polyoma and non-prognosis of poor coexistence of signs.