title: Surgical strategy of bilateral synchronous sporadic renal cell carcinoma-experience of a Chinese university hospital.
abstract: BACKGROUND
  The objective of this study is to investigate the optimal therapeutic protocol for BSSRCC.
  
  
  METHODS
  A total of 32 BSSRCC patients, including 28 males and 4 females, were enrolled the study from January 2004 to May 2016. The diagnoses were defined by the measurements of CT, ultrasound, and MRI. Patients with hereditary syndrome were excluded. The management of surgical manner, operation staging, and sequence were scheduled in accordance with the tumor's location and size (based on Zhongshan score, ZS score), as well as the performance status of the patients. Among them, 8 cases were conducted with bilateral surgical procedure simultaneously and 24 cases were implemented with staged operations. NSS on the one side with contralateral RN, and NSS on both sides were performed in 17 and 15 patients separately.
  
  
  RESULTS
  Thirty cases were conducted 56 operations in total. The average operation time was 260 ± 52 min in simultaneous operations and 162 ± 40 min in staged operations. The length of hospital stay in average was 11.5 ± 1.8 and 7.5 ± 1.4 days, respectively. Twenty-eight cases were followed up by 6-138 months. The level of creatinine was elevated in 5 cases without hemodialysis conducted.
  
  
  CONCLUSIONS
  The location and size of the carcinomas, and the performance status of patients should be considered in determination of an appropriate surgical approach. Both renal function preservation and tumor eradication were similarly critical, whereas the latter is of more importance. ZS score may be helpful in the dilemma. Longer follow-up period and more patient enrolment are required.
authors.affiliation: Department of Urology, Zhongshan Hospital, Fudan University, 180 Fenglin Rd, Shanghai, 200032, China.
authors.forename: Xiao-Yi
authors.initials: XY
authors.lastname: Hu
authors.affiliation: Department of Urology, Zhongshan Hospital, Fudan University, 180 Fenglin Rd, Shanghai, 200032, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Xu
authors.affiliation: Department of Urology, Zhongshan Hospital, Fudan University, 180 Fenglin Rd, Shanghai, 200032, China. guo.jianming@zs-hospital.sh.cn.
authors.forename: Jian-Ming
authors.initials: JM
authors.lastname: Guo
authors.affiliation: Department of Urology, Zhongshan Hospital, Fudan University, 180 Fenglin Rd, Shanghai, 200032, China. wang.hang@zs-hospital.sh.cn.
authors.forename: Hang
authors.initials: H
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D002681:China; D005260:Female; D005500:Follow-Up Studies; D006785:Hospitals, University; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate
keywords: Kidney neoplasm; Nephron-sparing surgery; Radical nephrectomy; Synchronous; ZS score