Are Small Renal Tumors Harmless? Analysis of Histopathological Features According to Tumors 4 Cm or Less in Diameter

Remzi, Mesut; Özsoy, Mehmet; Klingler, Hans-Christoph; Susani, Martin; Waldert, Matthias; Seitz, Christian; Schmidbauer, Joerg; Marberger, Michael

doi:10.1016/j.juro.2006.04.047

Cited by 300 publications

(185 citation statements)

References 16 publications

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“…On the other hand, only 6.3-7.1% are benign for lesions larger than 7.0 cm in diameter [21]. It has been reported that renal masses 3 cm in diameter have a more aggressive potential, resulting in more incidences of metastases [22,23] (Tables 2 and 3). Moreover, the proliferation rate should also be considered.…”

Section: Discussionmentioning

confidence: 98%

Pathological Grade and Gender are Predictors of Small Renal Cell Carcinoma Growth

Sugimoto¹

2014

J Integr Oncol

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Objective: This study was undertaken to investigate the clinicopathological factors that influence the growth of a small renal mass (SRM) in patients subjected to a delayed surgery intervention. Methods:We reviewed the clinical records of 37 patients with SRM 4 cm at diagnosis, who underwent delayed surgical intervention during surveillance from January 2000 to December 2013. Radiographic evaluation using computed tomography (CT) scan, magnetic resonance imaging (MRI) were performed at least every 6 months and the tumor size was determined at least twice.Results: Histopathological analysis revealed that in 35 of the 37 patients the tumor was malignant in stage pT1aN0M0. There were 28 clear cell carcinomas and 7 non clear cell carcinomas. There was a significant difference in the time to tumor doubling (TTD) among clear cell carcinomas (p=0.033). There was also a significant difference in the tumor growth rate (mm/year) of clear cell carcinomas between male and female patients (p=0.028). Conclusion:The growth rate of small renal mass was slow in the majority of our patients. Pathological grade and gender significantly influenced the growth of clear cell carcinomas.

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Section: Discussionmentioning

confidence: 98%

Pathological Grade and Gender are Predictors of Small Renal Cell Carcinoma Growth

Sugimoto¹

2014

J Integr Oncol

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“…RN, KBY gelişimi için önemli bir risk faktörüdür. Küçük renalkortikal tümörlerin yaklaşık %20'sinin benign patolojiye sahip olduğu için, RN'nin artık altın standart yöntem olarak görülmemesi gerektiği kabul edilmiş bir gerçektir (6,18). Mayo klinik ekibinin 2000 yılında tek taraflı RHK, diğer böbreği ve kreatinin değeri normal olan hastalarda RN ile NKC'yi karşılaştırdığı bir çalışmada kreatinin değerinin >2 mg/dl olması şeklinde tanımlandığı kronik renal yetmezlik, 10 yıllık takip sonunda RN grubunda %22,4 iken NKC grubunda %11,6 olarak bulunmuştur.…”

Section: Discussionunclassified

The Effects of Radical Nephrectomy and Nephron Sparing Surgery on Glomerular Filtration Rate for the Patients who Underwent Surgery for Localized Renal Mass

Güdeloğlu¹,

Akdoğan²

2016

Acta Oncol Tur.

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ÖZETAmaç: Bu çalışmada, radikal nefrektomi (RN) ile nefron koruyucu cerrahinin (NKC) uzun dönem böbrek fonksiyonları üzerine etkisini ortaya koymak amaçlanmıştır. Hastalar veYöntem: Hacettepe Üniversitesi Tıp Fakültesi Üroloji Anabilim Dalı'nda Ocak 1990 -Nisan 2011 tarihleri arasında renal kitle nedeniyle ameliyat edilen 1016 hastaya ait veriler, retrospektif olarak incelenmiştir. Tanı anında metastatik olduğu bilinen 78 olgu çalışma dışı tutulmuştur. Bulgular: Çalışmaya alınan olguların 579'u (%61,7) erkek ve 359'u (%38,3) kadındır. 624 olguya RN, 314 olguya NKC yapılmıştır. Hastaların ortalama takip süresi RN yapılan grupta 46.7 ay iken, NKC uygulanan grupta 39.9 aydır. Ortalama radyolojik tümör boyutu sırasıyla 75±33,5 mm ve 37,8±26 mm'dir (p<0.001). Ortalama ameliyat süresi RN ve NKC grupları için sırasıyla 137.6 ve 139.5 dakikadır. NKC uygulanan grupta ortalama sıcak iskemi süresi 18,9±6,8 (3-36) dakikadır. Uzun dönem takip sonunda RN yapılan gruptaki kreatinin değerindeki ortalama 0,51 mg/dl artış, NKC uygulanan gruptaki 0,39 mg/dl artıştan anlamlı şekilde daha fazladır (p<0.001). Uzun dönem takipte preoperatif GFR'ı ≥60 olan hastaların halen GFR değerinin ≥60 olarak devam etme oranları, RN ve NKC yapılan gruplarda sırasıyla %47.6 ve %74.8 olarak tespit edilmiştir (p<0.001). Sonuç: Çalışmamızda GFR'de azalma oranının uzun dönemde RN yapılan hastalarda NKC yapılanlara göre daha fazla olduğu bulunmuştur. T1 renal tümörü olan birçok olguda RN ile bütün böbreği çıkarmak fazladan tedavidir. T1 renal tümörü olan hastalarda teknik olarak mümkün oldukça parsiyel nefrektomi tercih edilmelidir. Anahtar kelimeler: Renal Hücreli Karsinom, Radikal Nefrektomi, Nefron Koruyucu Cerrahi, Glomerüler Filtrasyon Oranı ABSTRACT Objectives: The goal of this study was to demonstrate the long-term effects of radical nephrectomy (RN) and nephron sparing surgery (NSS) on kidney functions. Patients and Methods: The medical records of 1016 patients who underwent kidney surgery from January 1990 to April 2011 at Hacettepe University School of Medicine, Department of Urology were retrospectively collected and analyzed. Metastatic 78 patients at presentation were excluded. Results: Radical nephrectomy and nephron sparing surgery was performed in 624 and 314 cases, respectively. Male to female ratio was 579/314. The mean follow up was 46.7 and 39.9 months for RN and NSS, respectively. The mean radiological tumor size was 75±33,5 mm for RN and 37,8±26 mm for NSS (p<0.001). The mean duration of surgery for RN and NSS was 137 and 139 minutes, respectively. The mean warm ischemia time for NSS was 18.9 minutes. Serum creatinin level was increased 0.51mg/dl and 0.39mg/dl for RN and NSS after long-term follow up, respectively (p<0.001). Glomerular filtration rate (GFR) was ≥ 60 ml/min/m 2 in 47.6% and 74.8% of RN and NSS patients in long-term follow up, respectively (p<0.001). Conclusion: Decrease in GFR was more prominent in RN compared to NSS patients in long term. Therefore, removing the whole kidney for especially T1 renal tumours is over ...

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“…Numerous studies have reported a higher proportion of benign pathology for small renal masses treated surgically. 6,9,11,12,[16][17][18][19] In a series by Schachter and colleagues, 26.3% of masses ≤4 cm were benign. 12 Similarly, Pahernik and colleagues reported a proportion of benign disease of 24.4% in a series of 504 patients treated with partial nephrectomy over 25 years.…”

Section: Discussionmentioning

confidence: 99%

Tumour location as a predictor of benign disease in the management of renal masses

Mason¹,

Abdolell²,

Rendon³

2013

CUAJ

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Objective: To investigate the association between tumour location and the proportion of benign disease in renal masses presumed to be renal cell carcinoma (RCC) preoperatively. Methods: This Institutional Review Board approved study includes 196 patients who underwent surgical treatment for renal masses <5 cm at our institution by a single surgeon between January 2002 and June 2009. Based on preoperative imaging, each mass was designated as central (touching or encroaching upon the renal collecting system and/or renal sinus) or peripheral. The association between tumour location and benign pathology was determined using univariate and multiple logistic regression, including tumour size and patient sex in the model. Results: The proportion of histologically confirmed benign disease in this series was 11.2%. The proportion of benign disease by location was 5.9% and 19.5% for central and peripheral masses, respectively. The effect of location was found to have a significant prognostic value (p = 0.0273) with an adjusted odds ratio of 3.51 (95% CI = 1.38-19.62) for the odds of a benign diagnosis in peripheral compared to central tumours. Tumour size and patient sex were not significant predictors of benign pathology (p = 0.483 and 0.191, respectively). Conclusions: Peripherally located renal masses are more likely to be benign than centrally located renal masses. This information may be used when selecting strategies for the management of renal masses presumed to be RCC.

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Are Small Renal Tumors Harmless? Analysis of Histopathological Features According to Tumors 4 Cm or Less in Diameter

Cited by 300 publications

References 16 publications

Pathological Grade and Gender are Predictors of Small Renal Cell Carcinoma Growth

Pathological Grade and Gender are Predictors of Small Renal Cell Carcinoma Growth

The Effects of Radical Nephrectomy and Nephron Sparing Surgery on Glomerular Filtration Rate for the Patients who Underwent Surgery for Localized Renal Mass

Tumour location as a predictor of benign disease in the management of renal masses

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