International Urology and Nephrology

, Volume 50, Issue 4, pp 657–663 | Cite as

Outcomes of synchronous and metachronous bilateral small renal masses (< 4 cm): a population-based cohort study

  • Nissar Ahmed Sheikh
  • Mohammed Hassan Khan
  • Sanjay Pillai
  • Stephen Lang
  • Ghulam Nabi
Urology - Original Paper



To report longitudinal outcomes of a population-based cohort of patients diagnosed with bilateral small renal masses from a period of over 11 years.

Patients and methods

Consecutive patients diagnosed with bilateral small renal masses (synchronous or metachronous) of a defined geographical area were recorded in a large database (TUCAN database) between January 2005 and December 2016. Patients had a unique identifier number and followed during this period using an agreed upon protocol. Clinicopathological characteristics and outcomes of bilateral small renal masses on active surveillance were analysed and compared to propensity score-matched sporadic unilateral small renal masses. Data were analysed for renal mass growth rate, rate of intervention and development of metastatic disease and patient survival.


A total of 1060 patients were diagnosed with renal cancer, of which bilateral small renal masses accounted for 70 (6.6%) cases. Synchronous SRMs were observed in 63 patients, whereas metachronous lesions were found in seven patients during the study period. Metachronous lesion mean time to appearance was 62 ± 41 months (range 9–149 months). While most cases were sporadic, four were found to be hereditary. Growth rate of bilateral small renal masses did not differ from that of unilateral sporadic small renal masses. Similarly, there were no differences between the groups for rate of interventions and survival.


Progression, rate of metastases and survival for patients diagnosed with bilateral small renal masses are similar to those diagnosed with unilateral disease.


Renal cancer Surgery Nephrectomy Active surveillance 



Research study did not have any external funding

Compliance with ethical standards

Conflict of interest

There is no conflict of interest declared by authors for the work presented in this study.

Ethical approval

All data collected in the study involving human participants were in accordance with the ethical standards of the institutional approval, and approval numbers were Caldicott/CSAppGN021211; Caldicott/IGTCAL2973.

Supplementary material

11255_2018_1817_MOESM1_ESM.jpg (73 kb)
Fig. 3, supplementary: Outcomes of small renal masses (bilateral vs. unilateral) on follow-up. (JPEG 72 kb)
11255_2018_1817_MOESM2_ESM.jpg (59 kb)
Fig. 4, supplementary: Multiple bilateral renal masses in a patient with VHL hereditary disease. Larger lesions were targeted using minimally invasive ablative technique. (JPEG 58 kb)
11255_2018_1817_MOESM3_ESM.png (305 kb)
Fig. 5, supplementary: Image-guided biopsy-confirmed oncocytoma as seen on MRI in an eighty-year-old lady with history of previous laparoscopic radical nephrectomy for contralateral small renal mass. (PNG 305 kb)
11255_2018_1817_MOESM4_ESM.tif (839 kb)
Fig. 6, supplementary: Metastasis-free survival in unilateral vs. bilateral (non-hereditary) small renal masses (TIFF 838 kb)


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Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  • Nissar Ahmed Sheikh
    • 1
  • Mohammed Hassan Khan
    • 1
  • Sanjay Pillai
    • 1
  • Stephen Lang
    • 1
  • Ghulam Nabi
    • 1
  1. 1.Academic Urology Unit, Cancer Research Division, Department of Urology, School of Medicine, Ninewells HospitalUniversity of DundeeDundeeScotland, UK

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