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目的:探讨双侧肾癌(Bilateral renal cell carcinoma,BRCC)患者的诊治与预后。方法:1999年1月～2006年1月我院共诊治BRCC患者6例,平均发病年龄53(35～74)岁。其中双侧同时性肾癌3例,异时性肾癌3例。肿瘤位于肾上极6枚,中极7枚,下极1枚;左肾6枚,右肾8枚;肿瘤平均直径4.6(3～7)cm。3例同时性肾癌患者,2例行双侧同期手术,1例行分期手术。其中2例行一侧肾癌根治术,对侧保留肾单位手术(NSS);1例一侧先行NSS,2周后再行对侧肾癌根治术。3例异时性肾癌患者均行分期手术治疗,均行一侧肾癌根治术,对侧NSS术。结果:6例随访12～156个月,平均84.5个月。肿瘤转移2例,分别死于肺转移和骨转移;肿瘤局部复发2例;无瘤生存2例。结论:NSS是目前较为理想的双侧肾癌治疗方法。治疗双侧肾癌的原则为尽可能切除肿瘤和最大限度保存肾功能。
Objective: To investigate the diagnosis and treatment of bilateral renal cell carcinoma (BCC). Methods: From January 1999 to January 2006, 6 patients with BRCC were diagnosed and treated in our hospital. The average age of onset was 53 (range 35-74) years. Including bilateral renal cell carcinoma in 3 cases, 3 cases of metachronous renal cell carcinoma. Tumor located in the kidney on the pole 6, 7 in the pole, pole 1, left kidney 6, right kidney 8; tumor average diameter 4.6 (3 ~ 7) cm. 3 cases of patients with simultaneous renal cell carcinoma, 2 cases of bilateral simultaneous surgery, 1 case of staging surgery. Among them, 2 patients underwent radical nephrectomy with contralateral nephron preservation (NSS); one patient had NSS first and the other received radical nephrectomy 2 weeks later. All three patients with synchronous renal cell carcinoma underwent staged surgery. All patients underwent radical nephrectomy and contralateral NSS. Results: Six cases were followed up for 12 ~ 156 months with an average of 84.5 months. Tumor metastasis in 2 cases, respectively, died of lung metastases and bone metastases; tumor local recurrence in 2 cases; 2 cases of tumor-free survival. Conclusion: NSS is the ideal treatment for bilateral renal cell carcinoma. The principle of treatment of bilateral renal cell carcinoma as much as possible to remove the tumor and maximize renal function.