晚期肾盂输尿管移行细胞癌常并发转移和输尿管壁间段肿瘤侵犯。本文报告4例肾盂输尿管移行细胞癌合并肺或输尿管旁淋巴结转移及患侧输尿管壁间段肿瘤侵犯，术前组织多学科讨论，按照多学科治疗模式联合微创手术治疗。

收治本院晚期上尿路移行细胞癌4例，男性3例，女性1例；平均年龄73岁；平均血尿病史10个月；3例肾盂输尿管全程侵犯，4例均有患侧输尿管壁间段肿瘤侵犯，3例肾盂输尿管周围淋巴结侵犯，1例肺转移。4例患者均行多学科联合治疗，所有患者接受新辅助治疗后均接受微创手术治疗（3例机器人辅助、1例腹腔镜辅助）。选择1例肺转移和肾盂及输尿管周围淋巴结侵犯做多学科病例分析汇报。

4例手术均顺利完成，术后予辅助治疗，中位随访时间为33个月，4位患者健侧肾功能正常，且无肿瘤复发。

晚期上尿路移行细胞癌多学科治疗模式中，选择合适病例切除病灶（包括输尿管壁间段肿瘤）能有效延长患者肿瘤特异性生存率。

Advanced transitional cell carcinoma (TCC) in renal pelvic and ureter was commonly observed with tumor invasion in ureter orifice or lymph node or metastasis in the lungs. Herein, 4 such cases were presented in multi-disciplinary team (MDT) model for individual treatment.

Four cases with TCC complicated with ureter orifice invasion and lymph node or lung metastasis were introduced. Of 4 cases, 3 were male, 1 was femal; the average age was 73 years and history of hemoturia was 10 months; 3 cases were observed of tumor involvement in whole length of ureter; all 4 cases were presented with ipsilateral ureter orifice invasion and retroperitoneal or pelvic lymph node invasion and one experienced lung metastasis. In accordance with MDT protocol, endoscopic radical renal-ureterectomy was performed.

All the 4 patients were successfully operated and received adjuvant therapy after operation. The median follow-up time was 33 months. The renal function of the healthy side of 4 patients was normal and no tumor recurrence was found.

In MDT model, it is novel to good prognosis after radical incision of TCC tumor mass for patients with advanced TCC.