Whang M, O'Toole K, Bixon R, Brunetti J, Ikeguchi E, Olsson C A, Sawczuk T S, Benson M C
Department of Urology, Columbia University College of Physicians and Surgeons, J. Bentley Squier Urological Clinic, New York, New York, USA.
J Urol. 1995 Sep;154(3):968-70; discussion 970-1.
A prospective study was performed to determine the incidence of multifocal renal cell carcinoma in patients who are candidates for partial nephrectomy.
Preoperative imaging studies and surgical specimens in 44 patients suitable for partial nephrectomy but undergoing radical nephrectomy were prospectively reviewed.
Of 44 renal cell cancers 11 (25%) demonstrated pathological multifocality, while 10 of 11 multifocal tumors (91%) occurred in the face of a primary tumor 5 cm. or smaller. Tumor multifocality was independent of the size of the primary renal tumor but occurred with a slightly higher frequency in tumors of stage T3A or greater even if the primary tumor was small.
Partial nephrectomy in patients with unilateral renal cancer should be approached with caution and should not be performed simply because it is technically feasible.