Abstract

BackgroundThe objective of this study is to investigate the optimal therapeutic protocol for BSSRCC.MethodsA total of 32 BSSRCC patients, including 28 males and 4 females, were enrolled the study from January 2004 to May 2016. The diagnoses were defined by the measurements of CT, ultrasound, and MRI. Patients with hereditary syndrome were excluded. The management of surgical manner, operation staging, and sequence were scheduled in accordance with the tumor’s location and size (based on Zhongshan score, ZS score), as well as the performance status of the patients. Among them, 8 cases were conducted with bilateral surgical procedure simultaneously and 24 cases were implemented with staged operations. NSS on the one side with contralateral RN, and NSS on both sides were performed in 17 and 15 patients separately.ResultsThirty cases were conducted 56 operations in total. The average operation time was 260 ± 52 min in simultaneous operations and 162 ± 40 min in staged operations. The length of hospital stay in average was 11.5 ± 1.8 and 7.5 ± 1.4 days, respectively. Twenty-eight cases were followed up by 6–138 months. The level of creatinine was elevated in 5 cases without hemodialysis conducted.ConclusionsThe location and size of the carcinomas, and the performance status of patients should be considered in determination of an appropriate surgical approach. Both renal function preservation and tumor eradication were similarly critical, whereas the latter is of more importance. ZS score may be helpful in the dilemma. Longer follow-up period and more patient enrolment are required.

Highlights

  • The objective of this study is to investigate the optimal therapeutic protocol for Bilateral synchronous sporadic renal cell carcinoma (BSSRCC)

  • We summarize the experience in the treatment of the BSSRCC and suggest the selection criteria of the surgical manner

  • According to the 2009 UICC/AJCC TNM staging system, 44 (68.8%) tumors were classified at T1aN0M0, 13 (20.3%) tumors were at T1bN0M0, 5 (7.8%) tumors were at T2N0M0, 1 (1.6%) tumor was at T3bN0M0, and other 1 (1.6%) tumor was at T2N1M0 (Table 1)

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Summary

Introduction

The objective of this study is to investigate the optimal therapeutic protocol for BSSRCC. Bilateral synchronous sporadic renal cell carcinoma (BSSRCC) is an uncommon disease accounting for 3~4.2% renal carcinomas [1, 2] It is a difficult surgical dilemma for the urologist to formulate the therapeutic strategy for individual patient. Singer et al [5] reported that the overall survival (OS) was 88% in the patients with synchronous sporadic carcinomas in a median 16-year follow-up period, which indicated the nephron-sparing surgery (NSS) was an essential procedure to bilateral renal tumors. They emphasized that all efforts should be

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