TY  - EJOU
AU  - Jacobs, Bruce L. 
AU  - Gibbons, Erin P. 
AU  - Gayed, Bishoy A. 
AU  - Whetstone, Joseph L. 
AU  - Jr., Ronald L. Hrebinko, 

TI  - Management of bilateral synchronous renal cell carcinoma in a single versus staged procedure
T2  - Canadian Journal of Urology

PY  - 2009
VL  - 16
IS  - 1
SN  - 1488-5581

AB  - <b>Objectives:</b> The presentation of synchronous bilateral renal lesions is rare. We report our experience with the surgical management of these lesions in both a single and staged procedure.<br/>
<b>Methods:</b> We retrospectively reviewed the records of all patients with bilateral synchronous renal lesions who underwent surgical management by one surgeon between 2000-2007. We compared characteristics including pre and postoperative renal function, complication rates, and oncological outcomes between the single and staged cohorts. Data were analyzed using descriptive statistics, Student's t-test, and Fisher's exact test.<br/>
<b>Results:</b> A total of 26 patients (73% male, mean age 65.5 ± 12.2 years) with bilateral synchronous lesions were identified with a mean follow-up of 25.9 ± 19.7 months. Of these, 18 (69%) were performed as a single procedure, 5 (19%) were done as a staged procedure, and 3 (12%) had only the first part of the staged procedure performed. The single and staged cohorts were comparable in regards to preoperative creatinine (Cr) (1.1 ± 0.4 mg/dl versus 1.1 ± 0.2 mg/dl, p = 0.70), postoperative Cr (1.5 ± 1.0 mg/dl versus 1.4 ± 0.5 mg/dl, p = 0.73), and median hospital length of stay (HLOS) (5 days versus 4 days). The complication rate was 22% and 20% for the single and staged cohorts, respectively. One patient had a local recurrence and one patient developed metastatic disease in the single cohort versus no local recurrence or metastatic disease in the staged cohort.<br/>
<b>Conclusion:</b> In the appropriate setting, surgical management of synchronous bilateral renal lesions can be done safely in a single procedure with comparable outcomes to those done in a staged manner.
KW  - renal cell carcinoma
KW  -  synchronous bilateral tumor
KW  -  kidney
KW  -  nephron sparing surgery

DO  -