OBJECTIVE: To examine our experience with managing sporadic bilateral renal masses, focusing on trends in surgical management over time, because as loss of renal function is associated with adverse cardiovascular outcomes, nephron-sparing approaches are increasingly emphasized in the treatment of @entity703 , creating new challenges for the treatment of @entity5 . @entity1 AND METHODS: We identified all @entity1 who underwent partial or radical nephrectomy ( @entity6841 or RN) at Memorial Sloan-Kettering Cancer Center (MSKCC) during 1989-2008. We compared @entity1 presenting with synchronous bilateral renal masses with those with @entity5 and evaluated trends in management using logistic regression. RESULTS: Of the 2777 @entity1 studied, 73 (3%) presented with synchronous bilateral disease. The overall survival and clinical/pathological features between groups were similar. Of those @entity1 receiving bilateral operations for @entity5 , three had bilateral RN (all before 2003), 28 (38%) had an RN followed by a @entity6841 , 10 (14%) had a @entity6841 then an RN, and 32 (44%) had bilateral @entity6841 . Over time, the proportion of @entity1 receiving bilateral @entity6841 increased (P < 0.001); 13 of 14 @entity1 after 2005 had bilateral @entity6841 , compared with only 34% (16 of 45) between 1995 and 2004. Forty-five @entity1 (62%) had the larger @entity5 removed during the first operation. The concordance rate between @entity5 in a specific histological subtype was 70% (51/73), and concordance for benign vs malignant disease was 90% (66/73). CONCLUSION: The use of @entity6841 in the management of synchronous bilateral renal masses has increased over time. The contemporary treatment of synchronous bilateral renal masses at MSKCC involves staged @entity6841 when feasible, with the more involved kidney (often larger @entity5 ) operated on first.

Developments in the surgical management of XXXX .

@entity5 :: ('MESH:D009369', 'Disease') :: ['unilateral tumour', 'synchronous tumours', 'bilateral tumours', 'tumours', 'tumour'] @entity1 :: ('9606', 'Species') :: ['patients', 'PATIENTS'] @entity6841 :: ('MESH:C565820', 'Disease') :: ['PN'] @entity703 :: ('MESH:D007680', 'Disease') :: ['kidney tumours']
@entity703 :: (MESH:D007680,Disease) :: ['sporadic synchronous bilateral renal tumours']
