Urology, Mayo Clinic, Rochester, MN 55905, USA.

To evaluate patients with multiple ipsilateral renal tumours and to determine outcomes of nephron-sparing surgery (NSS) and radical nephrectomy (RN), as the treatment of unrecognized sporadic multifocal tumours at NSS presents a surgical dilemma.

In all, 104 patients had surgery between 1970 and 2003 for sporadic multiple ipsilateral renal tumours, at least one of which was renal cell carcinoma (RCC); 114 were treated with RN and 26 with NSS. Cancer-specific survival (CSS) was estimated using the Kaplan-Meier method.

More patients treated with NSS had a solitary kidney than those undergoing RN (six, 23%, vs none, P < 0.001). Seventeen of the 114 having RN died from RCC at a median (range) of 3.4 (0.25-10.3) years after RN. The estimated 5-year CSS was 90.5%. There was metachronous recurrence in nine patients at a median of 5.6 (1-14 ) years after. Two of the 26 patients having NSS died from RCC at 1 and 6 years after NSS; the 5-year CSS was 95.8%. There was local or metachronous recurrence in three patients at 7 months to 6 years after surgery; all three were alive at the last follow-up. In 26 (23%) of the 114 patients treated with RN, only one tumour was RCC.

Patients undergoing either RN or NSS for multiple ipsilateral renal tumours have a favourable CSS. A planned NSS is safe if small satellite lesions are resectable.

Written by
Krambeck A, Iwaszko M, Leibovich B, Cheville J, Frank I, Blute M.

Reference
BJU Int. 2008 Jun;101(11):1375-9.
doi:10.1111/j.1464-410X.2008.07588.x

PubMed Abstract
PMID:18454793

UroToday.com Renal Cancer Section

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