The surgical treatment and prognosis of bilateral sporadic renal tumors / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the surgical management and prognostic characteristics of bilateral sporadic renal tumors (BSRTs).</p><p><b>METHODS</b>Twenty-three cases of BSRTs were identified and retrospectively reviewed. The presenting clinical findings, surgical treatment, and prognosis were evaluated.</p><p><b>RESULTS</b>Twelve patients had synchronous tumors and 11 had asynchronous tumors. BSRTs comprised 1.8% of all RCC cases with a male-to-female ratio of 6.671 in the same term. The mean age of patients was 56 years. Seventeen patients were preformed bilateral operation (10 had synchronous and 7 had asynchronous tumors), 4 patients were preformed unilateral operation (1 had synchronous and 3 had asynchronous tumors), and 2 patients were not performed operation (asynchronous tumors). Twenty-one patients were followed up (11 had synchronous tumors and 10 had asynchronous tumors, mean 27 months). One and 5-years cancer specific survival rate of BSRTs were 84.6% and 33.5% respectively. The rate of renal failure of synchronous BSRTs (18%) was lower than that of asynchronous BSRTs (70%) after operation (P=0.030).</p><p><b>CONCLUSIONS</b>Prognosis of BSRTs is poor. The key in the treatment of BSRTs is to detect and resect tumor earlier. Our results indicate that nephron sparing surgery should be performed in order to obtain optimal functional preservation of the renal remnant with complete local excision of tumor.</p>