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[Synchronous bilateral renal adenocarcinoma. Our experience with conservative kidney surgery]
F J Pérez García1, F J Regadera Sejas, J J Rodríguez Martínez
1Servicio de Urología I, Hospital Covadonga, Oviedo, Asturias, España.
Objective:
To present our experience with synchronous bilateral renal adenocarcinoma. The indications for conservative surgery, the different types and the controversies are discussed.
Methods:
5 patients with bilateral renal adenocarcinoma from our series of 320 renal adenocarcinomas were analyzed for gender, age at presentation, tumor location, size, presenting features and type of surgery performed.
Results:
Bilateral renal adenocarcinoma accounted for 1.56% in our series. Mean age at presentation was 57.8 years (range 43-69 years). All 5 patients were male. All patients underwent conservative surgery by tumor excision or partial nephrectomy of the side with less involvement followed by delayed radical surgery of the contralateral side. Follow-up ranged from 19 months to 14 years. To date all patients are disease-free and only one is on dialysis 14 years postoperatively.
Conclusions:
Bilateral renal adenocarcinoma has been reported to account for 1.4%-5% of all renal masses. The incidence in our series was 1.56%. Conservative renal surgery is indicated in patients like those described herein to prevent the need for dialysis. In our view, conservative renal surgery is a good therapeutic option that carries a small risk of tumor multicentricity and future recurrence.