Bilateral synchronous renal masses (BSRMs) are a rare finding, and the optimal treatment strategy remains undetermined. This study depicts the management of BSRM at eight European high-volume centers.
This is a retrospective analysis of prospective institutional databases collecting all patients presenting with clinical T1-2 N0 M0 BSRMs between 1993 and 2020 at 8 tertiary referral high-volume centers for renal cancer treatment in Europe. The treatment options included active surveillance (AS), tumor ablation (TA) and surgery (partial and radical nephrectomy).
Overall, 134 patients were analyzed. Renal mass biopsy prior treatment was performed in 8% of cases. 15%, 4%, and 81% of patients underwent AS, a combination of surgery and TA, and bilateral (one-stage or two-stage) surgery. Among patients undergoing bilateral surgery (N.=109), a staged approach was chosen in 78% (N.=85) of cases treating the lower complexity tumor first in 51/85 (60%) cases and in 34/85 (40%) treating the higher complexity tumor first. Concordance of the histological analysis was found in 77% of patients with 10% of bilateral benign masses.
Even if considering only referral centers, a high heterogeneity for decision-making in the treatment of BSRM should be expected. Advances in genetic diagnosis, the implementation of novel imaging technologies, and the strengthening role of alternative treatment, may lead to a standardized decision-making process in the setting of BSRMs.
Minerva urology and nephrology. 2024 Dec [Epub]
Pietro Diana, Daniele Amparore, Riccardo Bertolo, Umberto Capitanio, Selcuk Erdem, Onder Kara, Tobias Klatte, Maximilian C Kriegmair, Carme Mir, Eduard Roussel, Riccardo Campi, European Association of Urology (EAU) Young Academic Urologists (YAU) Renal Cancer Group
European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, the Netherlands - ., European Association of Urology (EAU), Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem, the Netherlands., Urological Research Institute (URI), IRCCS San Raffaele Scientific Institute, Milan, Italy., Department of Urology, Kocaeli University School of Medicine, Kocaeli, Türkiye., Department of Urology, Helios Klinikum Bad Saarow, Bad Saarow, Germany., Urological Clinic Munich-Planegg, Planegg, Germany., Department of Urology, IMED Hospital, Valencia, Spain.