Experience gained from the management of 9 cases of bilateral renal cell carcinoma.

Radical nephrectomy is the traditional therapy for renal cell carcinoma. However, modification of this technique is necessary when bilateral renal cell carcinoma occurs (3.8 per cent of all renal cell carcinomas at our institution). Special attention should be paid to the contralateral kidney when the diagnosis of renal cell carcinoma is made, since an inapparent contralateral tumor may also be present (2 of 9 cases). An aggressive approach, consisting of in vivo heminephrectomy and a contralateral procedure, has avoided operative mortality or bench surgery, maintained life-sustaining renal function and produced a reasonable long-term survival rate.