Monocentric Retrospective Analysis On Renal Squamous Cell Carcinoma(Report Of Twenty-four Cases)

Objective: To discuss the pathogenesis,clinical features,treatment and prognosis of renal squamous cell carcinoma,so as to improve our understanding and diagnosis of this disease.Methodology: To retrospective analyze the patients who confirmed by pathology to suffer from squamous cell carcinoma after being hospitalized and operated in the First Affiliated Hospital of Guangxi Medical University over the past 16 years.The information of patient's data was collected from the patient's clinical cases and telephone follow-up.COX regression model is applied to calculate the factors affecting prognosis of renal squamous cell carcinoma,while Kaplan-Meier method and long-rank test are used to describe and test the univariate survival analysis.Result:(1)Among 24 patients with renal squamous cell carcinoma,there were 19 males,5 females,the average age was 58.3±9.1.15 cases lived in the countryside,9 cases lived in towns.17 patients were farmers,and 7 patients were non-farmers.(2)22 patients appear symptom with low back pain,91.7% of the selected cases;7 cases had gross hematuria,29.2% of the selected cases;19cases had different levels of microscopic hematuria,79.2% of the selected cases;21 cases had the history of calculu,87.5% of the selected cases;19 cases had hydronephrosis and/or pyonephrosis,79.2% of the selected cases.All 24 patients treated by surgery,and there were 4 patients receive chemoradiotherapy after surgery,16.7% of the selected cases.(3).COX analysis results show that the prognosis factors influencing tumor include: T staging(P=0.036),the degree of tumor differentiation(P=0.033).From multi-variate analysis it is concluded that T staging(0.036)is an independent factor influencing the prognosis of tumor.(4)There was not much difference between radical nephrectomy and radical nephroureterectomy for patients with squamous cell carcinoma is in renal pelvis.(5)No matter lymph node metastasis or chemoradiotherapy treatment is applied,survival time was not statistically significant difference.Conclusion:(1)Male,aged 50 years and older,living in regions with poor sanitary condition,which have the relatively high proportion among all patients of renal squamous cell carcinoma;(2)There were no obvious characteristics in the clinical symptoms of renal squamous cell carcinoma,and clinician should be vigilance for the occurrence of renal squamous cell carcinoma when patients were diagnosed with chronic kidney stone and(or)hydrops and(or)infection;(3)The influence factors of prognosis of renal squamous cell carcinoma include T-staging and the degree of tumor differentiation;T-staging is an independent factor influencing the prognosis of renal squamous cell carcinoma,and early detection andtreatment can increase prognosis of the patients;(4)For patients with squamous cell carcinoma of the renal pelvis,we can choice radical nephrectomy to reduced the difficulty of operation and reduce operation trauma;(5)Chemoradiotherapy was poor effect to renal squamous cell carcinoma,so it did not need to chemoradiotherapy after the surgery.