Surgical treatment of bilateral renal cell carcinoma


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The paper presents the results of surgical treatment of bilateral tumors of the kidneys. Bilateral neoplasms were detected in 28 of 1200 patients with renal cell carcinoma (2.3%). Synchronous tumors were found in 12 patients (42.8%), asynchronous - in 16 (57.2%). Operation on both the kidneys for tumor was carried out in 21 patients from 28 (75%). In both groups operations including enucleation of the tumors (60% in the group with synchronous cancer and 53.8%) in the group with asynchronous one) prevailed. All the patients were operated in two stages. Local relapses occurred in 6 of 21 patients (28.5%). A relapse after nephrectomy was observed in 2 patients (9.5%). Recurrent tumor in the remnant of the kidney after nephron-sparing surgery was observed in 4 patients (19%). General 5 year survival in patients with synchronous bilateral tumors was 38.5%, whereas 5-year cancer-specific survival reached 47.4%. For asychronous cancer these parameters were 49.6 and 58.7%, respectively. It is emphasized that all patients with renal cancer after radical nephrectomy should be followed up and undergo annual check-up with US and/or CT lifelong to detect possible asynchronous tumor. Genetic studies are necessary to specify differentiation of the form of bilateral neoplasm.

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