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Bilateral asynchronous renal cell carcinoma: treatment approach
O J Kessler1, P M Livne, C Servadio
1Urology Institute, Beilinson Medical Center, Petah Tikva, Israel.
Israel Journal of Medical Sciences
|November 1, 1993
Summary
Four patients developed a second renal cell carcinoma (RCC) in their remaining kidney after initial nephrectomy for RCC. Parenchymal-sparing surgery, like partial nephrectomy, offers a viable treatment option to preserve kidney function and avoid dialysis.
Area of Science:
- Urology
- Oncology
Background:
- Renal cell carcinoma (RCC) is a significant health concern.
- Nephrectomy is a common treatment for RCC, but carries risks for the remaining kidney.
Purpose of the Study:
- To investigate the incidence and management of asynchronous secondary RCC in the contralateral kidney after nephrectomy.
- To evaluate the efficacy of parenchymal-sparing procedures in treating secondary RCC.
Main Methods:
- Retrospective analysis of 200 patients who underwent nephrectomy for RCC between 1978-1989.
- Identification of patients who developed a second RCC in the remaining kidney.
- Review of treatment and outcomes for these patients, focusing on parenchymal-sparing procedures.
Main Results:
- Four out of 200 patients developed asynchronous secondary RCC in the remaining kidney, with a mean interval of 65 months post-nephrectomy.
- All four patients were treated with parenchymal-sparing procedures (one enucleation, three partial nephrectomies).
- Patients maintained kidney function post-procedure, with creatinine levels between 1.6-1.9 mg, and none required dialysis.
Conclusions:
- Asynchronous development of RCC in the contralateral kidney after nephrectomy is a rare but important consideration.
- Parenchymal-sparing procedures are effective in treating secondary RCC, preserving renal function, and improving quality of life.
- Awareness and consideration of these procedures are crucial for managing patients with a history of RCC.