Clinicopathological features and prognosis of synchronous bilateral renal cell carcinoma: an international multicentre experience.
OBJECTIVE
To present a multicentre experience and the largest cohort to date of nonmetastatic (N0M0) synchronous bilateral renal cell carcinoma (RCC), as because it is rare the single-institutional experience is limited.


METHODS
We retrospectively studied 10 337 patients from 12 urological centres to identify patients with N0M0 synchronous bilateral RCC; the clinicopathological features and cancer-specific survival were compared to a cohort treated for N0M0 unilateral RCC.


RESULTS
In all, 153 patients had synchronous bilateral solid renal tumours, of whom 135 (88%) had synchronous bilateral RCC, 118 with nonmetastatic disease; 91% had nonfamilial bilateral RCC. Bilateral clear cell RCC was the major histological subtype (76%), and papillary RCC was the next most frequent (19%). Multifocality was found in 54% of bilateral RCCs. Compared with unilateral RCC, patients did not differ in Eastern Cooperative Oncology Group performance status (ECOG PS) and T classification, but bilateral RCCs were more frequently multifocal (54% vs 16%, P < 0.001) and of the papillary subtype (19% vs 12%), and less frequently clear cell RCC (76% vs 83%, P = 0.005). For the outcome, patients with nonmetastatic synchronous bilateral RCC and unilateral RCC had a similar prognosis (P = 0.63); multifocality did not affect survival (P = 0.60). Multivariate analysis identified ECOG PS, T classification, and Fuhrman grade, but not laterality, as independent prognostic factors for cancer-specific survival.


CONCLUSIONS
Patients with N0M0 synchronous bilateral RCC and N0M0 unilateral RCC have a similar prognosis. The frequency of a familial history for RCC (von Hippel-Lindau disease or familial RCC) was significantly greater in bilateral synchronous than in unilateral RCC. The significant pathological findings in synchronous bilateral RCC are papillary subtype and multifocality.
Klatte
Tobias
T
Department of Urology, David Geffen School of Medicine at UCLA, University of California-Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90025, USA.
Wunderlich
Heiko
H
Patard
Jean-Jacques
JJ
Kleid
Mark D
MD
Lam
John S
JS
Junker
Kerstin
K
Schubert
Jörg
J
Böhm
Malte
M
Allhoff
Ernst P
EP
Kabbinavar
Fairooz F
FF
Crepel
Maxime
M
Cindolo
Luca
L
De La Taille
Alexandre
A
Tostain
Jacques
J
Mejean
Arnaud
A
Soulie
Michel
M
Bellec
Laurent
L
Bernhard
Jean Christophe
JC
Ferriere
Jean-Marie
JM
Pfister
Christian
C
Albouy
Baptiste
B
Colombel
Marc
M
Zisman
Amnon
A
Belldegrun
Arie S
AS
Pantuck
Allan J
AJ
D002292:Carcinoma, Renal Cell / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D009392:Nephrectomy / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis