The Incidence of Multifocal Renal Cell Carcinoma in Patients Who are Candidates for Partial Nephrectomy

Purpose: A prospective study was performed to determine the incidence of multifocal renal cell carcinoma in patients who are candidates for partial nephrectomy. Materials and Methods: Preoperative imaging studies and surgical specimens in 44 patients suitable for partial nephrectomy but undergoing radical nephrectomy were prospectively reviewed. Results: Of 44 renal cell cancers 11 (25 percent) demonstrated pathological multifocality, while 10 of 11 multifocal tumors (91 percent) occurred in the face of a primary tumor 5 cm. or smaller. Tumor multifocality was independent of the size of the primary renal tumor but occurred with a slightly higher frequency in tumors of stage T3A or greater even if the primary tumor was small. Conclusions: Partial nephrectomy in patients with unilateral renal cancer should be approached with caution and should not be performed simply because it is technically feasible.