Bilateral renal tumors: Description of clinicopathological characteristics of synchronous and metachronous presentation, oncological results and associated morbidity

Authors

  • Octavio Alejandro Fuentes-Méndez Secretaría de Salud, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, Ciudad de México, México.
  • David Gómez-Ortiz Secretaría de Salud, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, Ciudad de México, México.
  • Fernando Bernardo Gabilondo-Navarro Secretaría de Salud, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, Ciudad de México, México.
  • Francisco Rodríguez- Covarrubias Secretaría de Salud, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, Ciudad de México, México.

DOI:

https://doi.org/10.48193/revistamexicanadeurologa.v83i2.1015

Keywords:

Bilateral renal tumor, Concordance, Metachronous tumor, Synchronous tumor, Impaired renal function

Abstract

Objective: To describe the characteristics of bilateral renal tumors and its impact on postoperative renal function in patients from an institution in Mexico City.

Methods: From March 1980 to May 2021, 17 patients underwent surgery for bilateral renal tumors, 12 were synchronous and the rest metachronous. Oncological and functional characteristics were described.

Results: Mean age was 46.9+/-13.5 years. Four were women and thirteen men. The size of the "first" tumor was 4.85+/-2.59 cm and the "second" was 5.34+/-3.95 cm. In synchronous tumors, 9 radical and 3 partial nephrectomies were performed for the first tumor and 2 radical and 9 partial for the second tumor (1 patient is still on surveillance for the second tumor). In metachronous patients, 5 radical nephrectomies were performed for the first tumor, and 4 radical and 1 partial for the second tumor. The histological concordance in synchronous and metachronous was 91% and 80%, respectively. The preoperative eGFR was 77.53+30.44 (ml/min/1.73 m2) and postoperative 46.85+38.34, decreasing 35.8% after the second surgery. Follow-up was 88.7+/-44.5 months. Five patients (29.4%) recurred. Overall and disease-free survival were 67.5 and 43 months, respectively.

Conclusions: The histological concordance is in line with previous international reports. Postoperative eGFR decline was more significant in metachronous patients in whom the proportion of radical nephrectomies was higher. Therefore, it highlights the importance of performing partial nephrectomies whenever feasible.

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Published

2023-06-09

Issue

Vol. 83 No. 2 (2023): March-April

Section

Original articles

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