Table 2.
Comparative studies concerning synchronous bilateral renal masses
| Author (Years) | Country | Type of study | Cases | Type of surgery | Approach | Stages | Control | Type of surgery | Stages | Approach | Follow-up | Final conclusion |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Novick 1989 [20] | USA | Prospective | 28 | 5 bilateral PN 23 RN/PN | Open | In most cases two stages | 28 metachronous | Not reported | Not reported | Open | 50 months | 5-year patient survival rate is higher in SBRM than in metachronous RCC |
| Boorjian 2008 [21] | USA | Retrospective | 147 |
6 bilateral RN 82 RN/PN 46 Bilateral PN |
Open | – | 153 metachronous |
9 bilateral RN 97 RN/PN 5 bilateral PN |
Not reported | Open | 73 months | The CSS is better in SBRM than in metachronous RCC |
| Amano 2010 [22] | Japan | Retrospective | 31 |
22 PN/RN, 8 Bilateral PN 1 bilateral RN |
Open | 1 RN/RN and 9 PN/RN with one stage, 13/PN/RN and 8 PN/PN with two stages | 22 |
1 bilateral RN, 17 RN/PN 1 PN/RN, 1 bilateral PN, 2 RN/ surveillance |
Not reported | Open | 58 months | Prognosis of SBRM and unilateral RCC is similar. Metachronous bilateral RCC is associated with higher distant metastasis and mortality rate than SBRM |
| Berczi 2016 [23] | Hungary | Retrospective | 36 |
17 RN/PN 14 PN/RN 3 bilateral PN |
Open | Two stages | 24 metachronous | RN + PN | Not reported | Open | 57 months | In SBRM PN/PN and PN/RN guaranteed similar oncological and functional outcomes than RN/RN. Tumor progression and cancer-specific mortality were higher in metachronous group |
| Qi 2017 [24] | China | Retrospective | 88 |
40 bilateral PN 30 RN/PN 18 unilateral surgery |
Open | Two stages | 60 metachronous | Not reported | Two stages | 60 metachronous | 76 months | The prognosis in patients with metachronous and synchronous tumors is similar. The OS between patients with bilateral RCC is compatible with unilateral RCC |
| Kim 2021 [25] | South Korea | Retrospective | 44 | Unspecified bilateral PN and PN/RN | Open, laparoscopic, or Robot-assisted | Two stages | 45 metachronous |
Unspecified RN/PN |
Not reported | Open, laparoscopic, or Robot-assisted | 65 months | No significant difference in eGFR decline in SBRM group compared to unilateral RCC. No perioperative outcomes between SBRM and metachronous lesions |
| Packiam 2020 [26] | USA | Retrospective | 77 | Bilateral PN | 75 open and 2 minimally invasive | One stage | 30 | Bilateral PN | Two stages | 24 Open, 1 minimally invasive, 5 open/minimally invasive | 111 months | No significant differences in oncological outcomes between the simultaneous and staged surgeries |
| Di Maida 2022 [27] | Italy | Retrospective | 17 |
15 bilateral PN 1 PN/RN 1 RN/RN |
11 bilateral robot-assisted, 6 bilateral open |
One stage | 24 |
22 bilateral PN 2 PN/RN |
Two stages |
15 bilateral robot-assisted 2 robotic/open 7 bilateral open |
42 months | There were no significant differences between simultaneous or staged bilateral surgeries for SBRM in terms of LRFS and CSS |
| Pahernik 2007 [28] | Germany | Retrospective | 22 | Bilateral PN | Open | Two stages | 28 | RN/PN | Two stages | Open | 57 months | Whenever feasible, bilateral PN is the strategy for SBRM, to guarantee an optimal preservation of renal function |
| Simmons 2010 [29] | USA | Retrospective | 134 | Bilateral PN | Open or laparoscopic | Two stages | 86 RN + PN |
60 PN/RN 26 RN/PN |
Two stages | Open or laparoscopic | 66 months | Double PN should be preferred to preserve the renal function. The 5- and 10-year OS and CSS in patients with SBRM are similar to those with unilateral RCC |
| Wang 2016 [30] | China | Retrospective | 34 | Bilateral PN | Laparoscopic | Two stages | 24 |
10 PN/RN 12 RN/PN |
Two stages | Laparoscopic | 43 months | Two-stage bilateral PN guaranteed optimal preservation of renal function with satisfactory oncological outcomes. The OS and RFS in patients with SBRM is similar with those with unilateral RCC |
| Ching 2011 [31] | USA | Retrospective | 92 | Bilateral PN | Open | Two stages | 22 | Bilateral PN | Two stages | Laparoscopic | 66 months | OS of laparoscopic bilateral PN was higher than open approach, while similar results for CSS occurred. Laparoscopic approach was associated with a larger percent decrease in eGFR |
| Hillyer 2011 [32] | USA | Retrospective | 9 | Bilateral PN | Robot-assisted | Two stages | 17 | Bilateral PN | Two stages | Laparoscopic | 8 months | RPN guaranteed adequate oncological radicality, with shorter ischemia time and higher renal function preservation than laparoscopic approach |
RN radical nephrectomy, PN partial nephrectomy, RCC renal cell cancer, SBRM synchronous bilateral renal masses, OS overall survival, CSS cancer-specific survival, LRFS local recurrence free survival