Surgical strategy in treating synchronous sporadic bilateral renal cell carcinoma

Abstract

Objective To evaluate the impact of different surgical approach on postoperative renal function in patients with synchronous sporadic bilateral renal cell carcinoma (SSBRCC). Methods The medical records of 28 patients with SSBRCC were reviewed. Of all these cases, 21 patients were male and 7 were female, and the mean age was 51 (25-63) years. None of these cases had family history of renal carcinoma. The treatment and other clinical data were analyzed retrospectively. Results All of the 28 patients underwent bilateral surgeries. Single procedures were performed on 16 patients, of which, one underwent bilateral radical nephrectomy (RN), 8 bilateral nephron-sparing surgery (NSS) and 7 unilateral NSS combined with contralateral RN. Staged procedures were performed on 12 patients, of which bilateral NSS was on 5 patients (NSS-NSS group), NSS followed by RN (NSS-RN group) on 3 patients and RN followed by NSS (RN-NSS group) on 4 patients. In term of postoperative renal function preservation for SSBRCC patients, the standard NSS was better than RN. Between different staged procedures, NSS-NSS was the preferred choice, and the NSS-RN was superior to the RN-NSS. Conclusions In term of preservation of postoperative renal function, the staged procedures were recommended, and NSS was preferred in the first stage. In deciding the second stage surgical approaches, the surgeons should take the renal function preservation and the tumor size into consideration. Key words: Carcinoma, renal cell; Bilateral surgery; Strategy; Renal function