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2008 Annual Meeting Abstracts
The Impact Of Temporal Presentation On Clinical and Pathological Outcomes For Patients With Sporadic Bilateral Renal Masses
Stephen A Boorjian*1, Paul L Crispen*2, Christine M Lohse*2, Bradley C Leibovich*2, Michael L Blute*2
1Fox Chase Cancer Center, Philadelphia, PA;2Mayo Clinic, Rochester, MN
Introduction: The origin of bilateral renal masses has not been definitively established to date. Here, we evaluated the impact of synchronous versus metachronous presentation on clinicopathological outcomes of patients with bilateral renal masses.
Methods: We identified 310 patients who underwent surgical resection of sporadic bilateral renal tumors between 1970-2003, including 148 (47.7%) with synchronous tumors and 162 (52.3%) with metachronous lesions. Clinicopathological features of synchronous and metachronous tumors were compared. Survival rates for patients with synchronous (n=92) and metachronous (n=100) renal cell carcinoma (RCC) were estimated using the Kaplan-Meier method and compared with the log rank test.
Results: Metachronous tumors had a greater degree of pathological concordance than synchronous lesions, with 87.7% of metachronous tumors representing bilateral RCC, compared to 69.2% of synchronous masses (p=0.002). Patients with synchronous RCC tended to have an increased incidence of papillary RCC compared to patients with metachronous RCC, who were more likely to have bilateral clear cell RCC (p=0.076). A longer interval between tumors was inversely associated with the risk of cancer death for patients with metachronous RCC (HR 0.90, 95% CI 0.81-0.99, p=0.039). Compared to patients with metachronous RCC, patients with synchronous bilateral RCC had similar 10-year CSS (70.5% versus 69.4%, p=0.51) and OS (47.5% versus 51.2%, p=0.58).
Conclusions: Metachronous bilateral solid renal masses have a greater degree of pathological concordance and were more likely to represent malignancy. Surgical resection may provide durable cancer control for patients with bilateral RCC, with no difference in survival noted between synchronous and metachronous cancers.
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