Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Dec;188(6):2084-8.
doi: 10.1016/j.juro.2012.08.038. Epub 2012 Oct 18.

Outcomes of patients with surgically treated bilateral renal masses and a minimum of 10 years of followup

Eric A Singer  1 , Srinivas Vourganti, Kelly Y Lin, Gopal N Gupta, Peter A Pinto, Ardeshir R Rastinehad, W Marston Linehan, Gennady Bratslavsky
Affiliations

Outcomes of patients with surgically treated bilateral renal masses and a minimum of 10 years of followup

Eric A Singer et al. J Urol. 2012 Dec.

Abstract

Purpose: Nephron sparing surgery has been advocated for patients with bilateral renal masses but long-term functional and oncological outcomes are lacking. We report the outcomes of patients with bilateral renal masses and a minimum 10-year followup.

Materials and methods: Patients with bilateral renal masses evaluated at our institution who were treated with initial surgery at least 10 years ago and underwent interventions on each renal unit were included in the analysis. Collected data included demographics, hereditary diagnosis, number of renal interventions, renal function and mortality status. Overall and renal cell carcinoma specific survival was assessed. Comparisons were made of renal function and overall survival between groups with 2 renal units and a surgically solitary kidney.

Results: A total of 128 patients met study inclusion criteria. Median followup in our cohort was 16 years (mean 17, range 10 to 49). The median number of surgical interventions was 3 (range 2 to 10). Of the patients 87 (68%) required repeat interventions on the ipsilateral renal unit at last followup with a median of 6.2 years (range 0.7 to 21) between interventions. Overall and renal cell cancer specific survival was 88% and 97%, respectively. Six patients (4.7%) ultimately underwent bilateral nephrectomy. Although renal function was better preserved in patients with 2 kidneys (70 vs 53 ml/minute/1.73 m(2), p = 0.0002), there was no difference in overall survival between those with bilateral kidneys or a surgically solitary kidney.

Conclusions: At a minimum 10-year followup after initial surgery, nephron sparing surgery allowed for excellent oncological and functional outcomes. Despite the need for repeat surgical interventions, nephron sparing surgery enabled dialysis to be avoided in more than 95% of patients.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Kaplan-Meier Overall Survival (OS)
Overall Survival = 88% at a median follow-up of 16 years.
Figure 2
Figure 2. Kaplan-Meier RCC-Specific Survival (RCCSS)
Renal cell carcinoma-specific survival (RCCSS) = 97% at a median of 16 years of follow-up.
Figure 3
Figure 3. Kaplan-Maier Overall Survival (OS) of Anephric vs. Non-Anephric Patients
OS for patients who ultimately became anephric was significantly shorter (median 19 years vs. median not reached; P=0.008) when compared to those who had one or both renal units.
Figure 4
Figure 4. Kaplan-Meier OS Comparing Solitary to Bilateral Renal Units
There was no difference in overall survival between those with bilateral or solitary kidneys (21.5 vs. 20.8 years, respectively; P=0.85). However, estimated glomerular filtration rate (eGFR) was better preserved in patients with both kidneys (70 vs. 53 mL/min/1.73m2, respectively; P=0.0002).
See this image and copyright information in PMC

References

    1. Nguyen CT, Campbell SC, Novick AC. Choice of operation for clinically localized renal tumor. Urol Clin North Am. 2008;35(4):645–55. vii. - PubMed
    1. Campbell SC, Novick AC, Belldegrun A, Blute ML, Chow GK, Derweesh IH, et al. Guideline for management of the clinical T1 renal mass. J Urol. 2009;182(4):1271–9. - PubMed
    1. McKiernan J, Simmons R, Katz J, Russo P. Natural history of chronic renal insufficiency after partial and radical nephrectomy. Urology. 2002;59(6):816–20. - PubMed
    1. Thompson RH, Boorjian SA, Lohse CM, Leibovich BC, Kwon ED, Cheville JC, et al. Radical nephrectomy for pT1a renal masses may be associated with decreased overall survival compared with partial nephrectomy. J Urol. 2008;179(2):468–71. discussion 472-3. - PubMed
    1. Huang WC, Levey AS, Serio AM, Snyder M, Vickers AJ, Raj GV, et al. Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. Lancet Oncol. 2006;7(9):735–40. - PMC - PubMed

Publication types