Bilateral renal cell carcinoma: influence of synchronous and asynchronous occurrence on patient survival.

Twenty-seven patients with synchronous (19 cases) or asynchronous (8 cases) bilateral renal cell carcinoma were treated and followed for as long as 20 years. Tumor grade and stage generally were more favorable in the former group, which is reflected in the higher surgical intervention rate. Nonsurgical treatment yielded poor results. The 5-year survival rate for patients with synchronous bilateral renal cell carcinoma (77.8 per cent) was significantly higher than that for patients with asynchronous lesions (37.5% per cent). Because of its different presentation and favorable prognosis when treated surgically synchronous bilateral renal cell cancer should be distinguished from the asynchronous form, with its dismal outcome. For the latter cases thorough long-term followup may make early surgical intervention feasible, and thus, improve patient survival.