Page 11 - Read Online

Pecoraro et al. Mini-invasive Surg 2024;8:29 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2023.90

Review Open Access

Possible treatments for synchronous bilateral small

renal masses

Angela Pecoraro 1,2 , Pietro Diana 2,3
1
Department of Urology, Hospital Pederzoli, Peschiera del Garda, Verona 37019, Italy.
2
European Association of Urology (EAU) Young Academic Urologists (YAU) Renal Cancer Working Group, Arnhem 30016, the
Netherlands.
3
Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona 08025, Spain.
Correspondence to: Dr. Angela Pecoraro, Department of Urology, Hospital Pederzoli, Via Monte Baldo 24, Peschiera del Garda,
Verona 37019, Italy. E-mail: pecoraroangela@libero.it
How to cite this article: Pecoraro A, Diana P. Possible treatments for synchronous bilateral small renal masses. Mini-invasive Surg
2024;8:29. https://dx.doi.org/10.20517/2574-1225.2023.90

Received: 25 Jul 2023 First Decision: 20 May 2024 Revised: 13 Oct 2024 Accepted: 23 Oct 2024 Published: 9 Nov 2024
Academic Editor: Giulio Belli Copy Editor: Pei-Yun Wang Production Editor: Pei-Yun Wang

Abstract
Currently, there is no established consensus on the best treatment approach for patients with bilateral
synchronous renal masses (BSRM). The timing and method of managing these cases remain subjects of debate.
This review aims to summarize the available literature and explore the ongoing controversies surrounding this
topic. Three studies investigated non-surgical treatments within BSRM. Specifically, one study focused on active
surveillance (AS) and showed no statistical differences in terms of progression and development of metastatic
disease relative to their unilateral counterpart. Two studies investigated ablative techniques showing promising
results. Eight papers have been published regarding robot assisted partial nephrectomy (RAPN) for BSRM. All
these papers highlighted the safety, feasibility, and efficacy of bilateral RAPN for BSRM. Literature regarding
treatments other than surgery such as AS and ablative therapies (ATs) for BSRM is scarce, but promising.
Progression, rate of metastases and survival of BSRM are similar to unilateral disease, and AS is a safe option in
these cases. Few studies focused on RAPN related outcomes for BSRMs, but all confirmed the safety, feasibility,
and efficacy of this procedure. Finally, one step RAPN resulted as feasible as the two staged procedures, especially
when selective clamping techniques can be chosen.

Keywords: Ablation, active surveillance, bilateral kidney cancer, nephrectomy

© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

www.oaepublish.com/mis