Pathological Concordance and Surgical Outcomes of Sporadic Synchronous Unilateral Multifocal Renal Masses Treated with Partial Nephrectomy

Simhan, Jay; Canter, Daniel; Sterious, Steven; Smaldone, Marc C.; Tsai, Kevin; Li, Tianyu; Viterbo, Rosalia; Chen, David Y.T.; Greenberg, Richard E.; Kutikov, Alexander; Uzzo, Robert G.

doi:10.1016/j.juro.2012.08.092

Cited by 29 publications

(31 citation statements)

References 29 publications

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“…In the literature, we are aware of only 2 articles that reported synchronous clear cell RCC and papillary RCC in the same kidney, similar to our case [15, 16]. Simhan et al [15] reported the data of 97 patients who had multifocal renal tumors.…”

Section: Discussionsupporting

confidence: 77%

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Coexisting Papillary and Clear Renal Cell Carcinoma in the Same Kidney

Üstüner

Yaprak

Teke

et al. 2014

Case Reports in Urology

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Renal cell carcinoma (RCC) is the most common solid lesion of the kidney. Bilateral synchronous benign and malignant renal tumors have been defined in some reports. However, unilateral concordance of malignant renal tumors is very rare and there are only a few cases that had synchronous different subtypes of malignant renal tumors arising within the same kidney. Herein, we describe a 67-year-old male patient who had clear cell RCC and papillary RCC in his right kidney that were successfully treated with radical nephrectomy. We also reviewed the pertinent literature.

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Section: Discussionsupporting

confidence: 77%

“…Simhan et al [15] reported the data of 97 patients who had multifocal renal tumors. They reported 8 patients who had mixed (papillary and clear cell) RCC, all of which were treated by PN.…”

Section: Discussionmentioning

confidence: 99%

Coexisting Papillary and Clear Renal Cell Carcinoma in the Same Kidney

Üstüner

Yaprak

Teke

et al. 2014

Case Reports in Urology

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“…1 Traditionally, patients with unilateral synchronous multifocal disease were treated with radical nephrectomy (RN), thus avoiding possible residual ipsilateral lesions and achieving maximal oncologic benefit, despite the negative effects on renal function and risk of subsequent chronic kidney disease (CKD). 2,3 Recent reports indicate that partial nephrectomy (PN) for multifocal renal cortical tumors offers equivalent cancer-specific survival (CSS) to RN, with the added benefit of preservation of postoperative renal function with a limited complication profile. 3–5 …”

Section: Introductionmentioning

confidence: 99%

“…2,3 Recent reports indicate that partial nephrectomy (PN) for multifocal renal cortical tumors offers equivalent cancer-specific survival (CSS) to RN, with the added benefit of preservation of postoperative renal function with a limited complication profile. 3–5 …”

Section: Introductionmentioning

confidence: 99%

Partial and Radical Nephrectomy for Unilateral Synchronous Multifocal Renal Cortical Tumors

Kent

Larish

Winer

et al. 2015

Urology

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Objective To evaluate clinicopathologic characteristics and treatment outcomes of patients undergoing partial (PN) or radical nephrectomy (RN) for unilateral synchronous multifocal renal tumors. Methods We retrospectively reviewed medical records for 128 patients with non-metastatic unilateral synchronous multifocal renal tumors who underwent surgical resection at our institution from 1995 to 2012. Five patients with hereditary renal cell carcinoma were excluded. Differences between patient and tumor characteristics from the two nephrectomy groups were evaluated. Outcomes in terms of recurrence-free survival, overall survival, and chronic kidney disease upstaging were estimated using Kaplan-Meier methods. The log-rank test was used for group comparisons. Results The study cohort included 78 PN patients (63%) and 45 RN patients (37%); 17/95 planned PN (18%) were converted to RN. Tumor diameter and R.E.N.A.L. nephrometry scores were greater in RN patients (p<0.0001 and p=0.0002, respectively). Pathological stage T3 was seen in 40% of RN patients and 10% of PN patients (p=0.0002). Histologic concordance was apparent in 60/123 patients (49%). Median follow-up for patients alive without a recurrence was 4 years. Five-year recurrence-free survival was 98% for PN and 85% for RN. Five-year overall survival was 96% for PN and 86% for RN (p=0.5). Five-year freedom from chronic kidney disease upstaging was 74% for PN, and 55% for RN (p=0.11). Conclusion Partial nephrectomy for the treatment of unilateral synchronous multifocal renal tumors with favorable characteristics was associated with a low recurrence rate. These findings suggest PN is an appropriate management strategy for this group of carefully selected patients.

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“…[19][20][21] Simhan et al 19 reported a data of 97 patients who had multifocal renal tumors. They reported 8 patients who had mixed papillary and clear cell RCC, all of which were treated with partial nephrectomy.…”

Section: Discussionmentioning

confidence: 99%