Chinese Clinical Oncology

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Long-term outcomes of surgical treatment on patients with synchronous sporadic and non-metastatic bilateral renal cell carcinoma: a report of 16 cases

HAN Sujun, LU Li, WANG Dong, XIAO Zejun, SHOU Jianzhong, LI Changling.

  

  1. Department of Urology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences, Beijing 100021, China
  • Received:2015-09-22 Revised:2015-12-05 Online:2016-02-29 Published:2016-02-29
  • Contact: LI Changling

Abstract:

Objective To evaluate the long-term outcomes of surgical treatment on patients with synchronous sporadic and non-metastatic bilateral renal cell carcinoma(BRCC). Methods In this retrospective study, 16 patients with synchronous sporadic and nonmetastatic BBRC were enrolled from 2000 to 2010. All patients underwent staged surgical procedures, including nephron-sparing surgery(NSS) and radical nephrectomy(RN). According to the treatment protocol, 16 patients were assigned into unilateral RN followed by contralateral NSS(RN+NSS group, n=5), unilateral NSS followed by contralateral RN(NSS+RN group, n=8) or bilateral NSS(NSS+NSS group, n=3). The longterm oncological outcome and renal function were analyzed. Results A total of 33 renal tumors were found in the 16 patients, including T1a19 tumors(57.6%), T1b 10 tumors(30.3%), T2a 3 tumors(9.0%) and T3a 1 tumor(3.0%). The incidence of acute renal failure in RN+NSS group, NSS+RN group and NSS+NSS group were 80.0%, 25.0% and 0(P=0.028), respectively. None of the patients required temporary or permanent dialysis. The 3-, 5-year disease-free survival rates were 93.8% and 87.5%, and the corresponding overall survival rates were 100% and 100%, respectively. Conclusion Staged surgical procedures are safe and efficient in the treatment of patients with synchronous sporadic and non-metastatic BBRC, resulting in the preservation of renal function and long-term cancer control. Our strategy was in general to first attempt NSS of the more favorable tumor, followed by NSS or RN of the less favorable contralateral tumor within 6 weeks. This approach allows the patient to recover from possible acute renal failure after NSS.

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