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Multiple tumors in the same kidney: incidence and therapeutic implications
D Jacqmin1, C Saussine, D Roca
1Department of Urology, CHU Strasbourg, France.
European Urology
|January 1, 1992
Summary
Conservative kidney tumor surgery carries a 10% risk of leaving additional tumors undetected. No tumor size guarantees complete removal, necessitating careful consideration before standardizing this approach.
Area of Science:
- Urology
- Oncology
- Surgical Pathology
Background:
- Conservative surgery is frequently suggested for small kidney tumors.
- The risk of multifocal disease necessitates careful patient selection.
Purpose of the Study:
- To evaluate the incidence of multiple tumors in patients undergoing conservative surgery for small renal masses.
- To determine if a size threshold exists below which conservative surgery is definitively safe.
Main Methods:
- Retrospective review of pathology reports from 727 patients who underwent surgery for kidney tumors.
- Analysis of tumor multiplicity based on tumor diameter (≤5 cm, ≤4 cm, ≤3 cm).
Main Results:
- Multiple tumors were found in 10.1% (≤5 cm), 10.75% (≤4 cm), and 12.8% (≤3 cm) of cases.
- A consistent approximately 10% risk of multifocal disease was observed across different size criteria.
- No specific tumor size was identified as a reliable indicator for the absence of additional tumors.
Conclusions:
- Conservative surgery for small kidney tumors has an inherent risk of approximately 10% for leaving additional tumors in situ.
- There is no definitive size limit that ensures the absence of multifocal disease.
- These findings suggest that conservative surgery should not be routinely standardized without careful consideration of multifocal disease risk.