Arnoux V, Fiard G, Descotes J L, Rambeaud J I, Long J A
Grenoble University Hospital, France.
Minerva Urol Nefrol. 2012 Dec;64(4):287-93.
The aim of this paper was to evaluate the pathologic concordance of bilateral renal masses and the influence of synchronous or asynchronous occurrence on patient long term survival.
Thirty-one consecutive patients with bilateral synchronous (N.=17, 55.0%) or asynchronous (N.=14, 45.0%) renal masses were retrospectively reviewed from January 2000 to December 2010. We included all patients with confirmed diagnosis on pathologic examination of a specimen or a percutaneous biopsy and evidence of angiomyolipoma on CT. Survival was assessed using the Kaplan-Meier method. RESULTS. The first lesion was larger than the second (60 vs. 30 mm, P<0.001). Pathologic concordance rate between tumors was 87.1%. A clear cell carcinoma was associated with a papillary carcinoma in 3.2%, and an angiomyolipoma in 6.4%. Median time of occurrence of a metachronous lesion was 50 months (IQR: 24; 92). Disease-free survival at 5 and 10 years was 87.2% and 78.5%. No statistical difference in disease free survival was observed between synchronous and metachronous tumors. conclusion: Discordant pathology between bilateral renal masses is uncommon, with a slight probability of benign tumor. Occurrence of a metachronous tumor can exceed 10 years.
本文旨在评估双侧肾肿块的病理一致性以及同步或异时发生对患者长期生存的影响。
回顾性分析2000年1月至2010年12月期间连续收治的31例双侧同步（n = 17，55.0%）或异时（n = 14，45.0%）肾肿块患者。纳入所有经标本病理检查或经皮活检确诊且CT显示有血管平滑肌脂肪瘤证据的患者。采用Kaplan-Meier法评估生存率。结果：第一个病灶大于第二个病灶（60对30 mm，P<0.001）。肿瘤之间的病理一致率为87.1%。透明细胞癌与乳头状癌同时存在的比例为3.2%，与血管平滑肌脂肪瘤同时存在的比例为6.4%。异时性病灶出现的中位时间为50个月（四分位间距：24；92）。5年和10年无病生存率分别为87.2%和78.5%。同步和异时性肿瘤之间在无病生存率方面未观察到统计学差异。结论：双侧肾肿块之间病理不一致情况不常见，良性肿瘤可能性较小。异时性肿瘤的出现时间可超过10年。
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