Herranz Amo F, Diez Cordero J M, Verdú Tartajo F, Diez Nau D, Rascón J J, Moncada Iribarren I, Lledó García E, González Chamorro F, Rodríguez Fernández E
Servicio de Urología, H.G.U. Gregorio Marañón, Universidad Complutense, Madrid.
Actas Urol Esp. 1996 Jan;20(1):22-9.
Unsuspected multicentricity in single Renal Adenocarcinoma (RAC) together with the prospects of incomplete neoplasia removal are the 2 major disadvantages for the acceptance of traditional renal surgery in birenal carriers of medium size, low grade single RAC. This paper is a retrospective review of our series of RAC patients who underwent radical nephrectomy between January 1986 and October 1994 with the following purpose: 1) To evaluate our incidence of unsuspected multicentricity. 2) To evaluate the characteristics of such multicentricity. 3) To evaluate, in the assumption that traditional surgery had been indicated for patients with small size RAC, in how many patients tumoral resection would have been incomplete due to existence of satellite tumoral nodes in the preserved renal parenchyma. Of 110 patients undergoing radical nephrectomy, 11.8% (13/110) had unsuspected multicentricity. In 10 patients there was multiple satellite nodes with size ranging from 0.3 to 3 cm. We conclude that there is not relationship between multicentricity and size or stage of primary tumour and that, by applying strict criteria (size, location, well defined tumoral wall and form of presentation) to select the patients who can be candidates to traditional renal surgery, the probability to perform it in patients with multicentric RAC would be considerably reduced.
单个肾腺癌（RAC）中未被怀疑的多中心性，以及肿瘤切除不完全的可能性，是中度大小、低级别单个RAC双侧肾患者接受传统肾脏手术的两个主要不利因素。本文回顾性分析了1986年1月至1994年10月期间接受根治性肾切除术的一系列RAC患者，目的如下：1）评估未被怀疑的多中心性的发生率。2）评估这种多中心性的特征。3）假设对于小尺寸RAC患者采用传统手术，由于保留肾实质中存在卫星肿瘤结节，有多少患者的肿瘤切除会不完全。在110例接受根治性肾切除术的患者中，11.8%（13/110）存在未被怀疑的多中心性。10例患者有多个卫星结节，大小从0.3厘米到3厘米不等。我们得出结论，多中心性与原发肿瘤的大小或分期之间没有关系，并且通过应用严格的标准（大小、位置、边界清晰的肿瘤壁和表现形式）来选择适合传统肾脏手术的患者，多中心RAC患者进行该手术的可能性将大大降低。
