title: Clinicopathological features and prognosis of synchronous bilateral renal cell carcinoma: an international multicentre experience.
abstract: 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.
authors: Department of Urology, David Geffen School of Medicine at UCLA, University of California-Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90025, USA.
authors: Tobias
authors: T
authors: Klatte
authors: Heiko
authors: H
authors: Wunderlich
authors: Jean-Jacques
authors: JJ
authors: Patard
authors: Mark D
authors: MD
authors: Kleid
authors: John S
authors: JS
authors: Lam
authors: Kerstin
authors: K
authors: Junker
authors: Jörg
authors: J
authors: Schubert
authors: Malte
authors: M
authors: Böhm
authors: Ernst P
authors: EP
authors: Allhoff
authors: Fairooz F
authors: FF
authors: Kabbinavar
authors: Maxime
authors: M
authors: Crepel
authors: Luca
authors: L
authors: Cindolo
authors: Alexandre
authors: A
authors: De La Taille
authors: Jacques
authors: J
authors: Tostain
authors: Arnaud
authors: A
authors: Mejean
authors: Michel
authors: M
authors: Soulie
authors: Laurent
authors: L
authors: Bellec
authors: Jean Christophe
authors: JC
authors: Bernhard
authors: Jean-Marie
authors: JM
authors: Ferriere
authors: Christian
authors: C
authors: Pfister
authors: Baptiste
authors: B
authors: Albouy
authors: Marc
authors: M
authors: Colombel
authors: Amnon
authors: A
authors: Zisman
authors: Arie S
authors: AS
authors: Belldegrun
authors: Allan J
authors: AJ
authors: Pantuck
mesh_terms: 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