Surgical implications of multicentricity in renal cell carcinoma.
OBJECTIVE
To determine the incidence and metastatic pattern of multifocal renal cell carcinoma in radical nephrectomy specimens and to use these findings to guide the choice of operative procedure.


METHODS
Pathology reports for 161 patients who underwent radical nephrectomy at Walter Reed Army Medical Center between 1980 and 1995 were reviewed to evaluate tumor size, stage, and incidence of multifocal tumors.


RESULTS
Multicentric neoplasms occurred in 16 of 161 (9.9%) radical nephrectomy specimens from the same institution. Thirteen of the 16 multifocal tumors had cross-sectional diameters > or = 3.5 cm. Of the 16 multifocal carcinomas, 11 were noted in stage I tumors. Multifocal neoplasms were not identified with primary tumors of < 2 cm.


CONCLUSIONS
Our data support previous reports that the incidence of multicentric renal malignancy is low and suggest that patients with small, unilateral masses (< 2 cm) can undergo kidney-sparing surgery with little risk of local recurrence.
Rosin
A
A
Aviation Medicine Clinic, Fort Huachuca, Sierra Vista, AZ 85635, USA.
Bauer
J J
JJ
Costible
R A
RA
D002292:Carcinoma, Renal Cell / Q000145:classification / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007680:Kidney Neoplasms / Q000145:classification / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery*; D008887:Military Medicine; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods; D018579:Patient Selection; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology