Table 4. A review of previous reports of the surgical management strategies for synchronous BRTs.
Reference | Surgical management preference |
---|---|
[11,19] (Mayo Clinic) | Single, transperitoneal procedure addressing the more difficult tumour first |
[9] (Cleveland Clinic) | Staged procedures, operating on the less involved tumour first |
[21] (M.D. Anderson) | Staged procedures; if tumours similar in stage, then operate on easier tumour first; if tumours discordant in stage, then operate on the higher stage tumour first |
[22] (International Consortium) | Included 12 centres with various approaches; 46% of patients had single procedure; 54% staged procedure |
[23] (Mainz, Germany) | Staged procedures, operating on the more favourable tumour first |
Present series | Staged procedures, operating on the more involved (often larger) tumour first |
All centres stress the importance of nephron preservation when possible. Surgical management preferences for BRTs were extracted from the listed publications. Clearly these strategies are often modified based on individual patients and situations.