Thorac Cardiovasc Surg 2021; 69(07): 672-678
DOI: 10.1055/s-0041-1727150
Original Thoracic

Metastases of Urothelium Carcinoma: Differential Diagnosis, Resection, and Survival

1   Department of Thoracic Surgery, Agaplesion Markus Krankenhaus, Wilhelm-Epstein-Str. 4, Frankfurt am Main, Germany
,
Stefan Sponholz
1   Department of Thoracic Surgery, Agaplesion Markus Krankenhaus, Wilhelm-Epstein-Str. 4, Frankfurt am Main, Germany
,
Moritz Schirren
1   Department of Thoracic Surgery, Agaplesion Markus Krankenhaus, Wilhelm-Epstein-Str. 4, Frankfurt am Main, Germany
,
Mesut Mese
1   Department of Thoracic Surgery, Agaplesion Markus Krankenhaus, Wilhelm-Epstein-Str. 4, Frankfurt am Main, Germany
,
Joachim Schirren
1   Department of Thoracic Surgery, Agaplesion Markus Krankenhaus, Wilhelm-Epstein-Str. 4, Frankfurt am Main, Germany
› Institutsangaben
Funding None declared.

Abstract

Background Due to its very aggressive nature and low survival chances, the metastasized urothelium carcinoma poses a challenge in regard to therapy. The gold-standard chemotherapy is platinum based. The therapy options are considered controversial, including new systemic therapies. In this respect, surgical therapies, as already established for pulmonary metastases of other tumor entities play an increasingly important role. The consumption of nicotine is a risk factor not only for urothelium carcinoma but also for a pulmonary carcinoma. Thus, we examined the frequency of a second carcinoma in this cohort.

Methods We retrospectively examined patients who had a differential diagnosis of pulmonary metastases, as well as those patients who underwent a surgery due to pulmonary metastases of a urothelium carcinoma between 1999 and 2015.

Results A total of 139 patients came to our clinic with the differential diagnosis of pulmonary metastases of a urothelium carcinoma. The most common diagnosis was pulmonary carcinoma (53%). Thirty-one patients underwent surgeries due to pulmonary metastases of a urothelium carcinoma. The median survival was 53 months and the 5-year survival was 51%. With the univariate analysis, only the relapse-free interval of more than 10 months was statistically significant (p < 0.001).

Conclusion There is a high coincidence of urothelial carcinoma and lung carcinoma. A histological confirmation should be endeavored. Selected patients undergoing a pulmonary metastasis resection have a survival advantage during the multimodal treatment of pulmonary metastasized urothelial carcinomas. For a definitive recommendation, randomized trials including a uniform multimodal therapy regimen and higher numbers of patients are necessary.



Publikationsverlauf

Eingereicht: 31. August 2020

Angenommen: 05. Februar 2021

Artikel online veröffentlicht:
16. April 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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