Purpose : We aimed to identify the patterns and combinations of second primary malignancies (SPMs) observed in patients with malignant neoplasms of the urinary tract (MNUT) and to explore the independent risk factors for survival outcomes in these patients. Materials and Methods: We analysed the data of MNUT patients with SPM in 25 hospitals in Shanghai between 2002 and 2015. A life table was used to calculate the survival rates, Kaplan–Meier analysis was used to determine the survival status of MNUT patients, and Cox regression analysis was used to perform multivariate analysis of survival risk factors in MNUT patients with SPM. Results: Among the 154 patients included, the first primary malignancy (PM) most commonly occurred in the bladder (50.65%) and kidney (41.56%), and the SPM most commonly occurred in the lung (22.73%) and stomach (13.64%). The most common combinations included the bladder + lung and bladder + stomach. The Cox regression results showed that age older than 60 years (HR = 2.36 [95% CI 1.30–4.28] vs. age <=60 years, p = 0.005), TNM 1 stage III+IV disease (HR = 2.19 [95% CI 1.37-4.57] vs. I+ II), p = 0.037), TNM 2 stage III+IV disease (HR = 7.43 [95% CI 1.49-19.68] vs. I + II), p <0.001), and SPM in the lung (HR = 4.36 [95% CI 1.74-18.69], p = 0.047) were associated with a significantly worse cancer-specific survival. Conclusion: The survival of MNUT patients with SPM may be related to the SPM site, first and second PM staging and latency time.

The authors have declared no competing interest.

The study design was supported by the Shanghai Excellent Young Talents Project in Health System (71774116 71603182). Data extraction was financially funded by the National Natural Science Foundation of China (72004032). The analysis and interpretation of the data were guided by statisticians and funded by grants from the Shanghai Public Health Outstanding Young Personnel Training Program (GWV-10.2-XD07). The writing and revision, including language improvement, were sponsored by the Chenzhou science and Technology Bureau Funds (JSYF2017038) and Chenzhou science and Technology Bureau Funds (ZDYF201816), the Special project for clinical research of health industry of Shanghai Municipal Health Commission (20204Y0166), Shanghai Public Health System Construction Three-year Action Plan Outstanding Youth Talent Training Program (GWV-10.2-YQ43) and the Chenzhou science and Technology Bureau Funds (ZDYF2020072).

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Not Applicable

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical approval for the research protocol was provided by the Medical Research Ethics Committee of the School of Public Health, Fudan University (IRB#2016-04-0586). Information was de-identified prior to analysis. The guidelines outlined in the Declaration of Helsinki were followed.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Not Applicable

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Not Applicable

I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.

Not Applicable

The data are available on request from the corresponding author.