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.

中文翻译：

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尿路上皮癌的转移：鉴别诊断、切除和存活

背景 由于其非常具有侵略性的性质和低存活率，转移性尿路上皮癌对治疗提出了挑战。金标准化疗是基于铂的。治疗选择被认为是有争议的，包括新的全身治疗。在这方面，已经为其他肿瘤实体的肺转移建立的手术疗法发挥着越来越重要的作用。尼古丁的消耗不仅是尿路上皮癌的危险因素，也是肺癌的危险因素。因此，我们检查了该队列中第二种癌症的频率。方法 我们回顾性检查了 1999 年至 2015 年间鉴别诊断为肺转移的患者以及因尿路上皮癌肺转移而接受手术的患者。结果 共有139例患者因尿路上皮癌肺转移的鉴别诊断来到我院。最常见的诊断是肺癌（53%）。31 名患者因尿路上皮癌的肺转移而接受了手术。中位生存期为 53 个月，5 年生存率为 51%。通过单变量分析，只有超过 10 个月的无复发间隔具有统计学意义（p < 0.001）。结论尿路上皮癌与肺癌的发生率较高。应努力进行组织学确认。接受肺转移切除术的特定患者在肺转移性尿路上皮癌的多模式治疗期间具有生存优势。对于明确的建议，