Pathological Features of Renal Neoplasms Classified by Size and Symptomatology

Schlomer, Bruce J.; Figenshau, R. Sherburne; Yan, Yan; Venkatesh, Ramakrishna; Bhayani, Sam B.

doi:10.1016/j.juro.2006.06.005

Cited by 115 publications

(96 citation statements)

References 17 publications

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“…The likelihood of benignity varies inversely with tumor size since about 25% of lesions 2 to 3 cm and 30% of those less than 2 cm are benign. 25 Therefore, to the extent that smaller masses are more likely to be ablated rather than resected our findings may underestimate the proportion of enhancing renal masses, as opposed to confirmed RCC, managed by nephron sparing in general and surveillance or focal ablation in particular. Notably the practice guideline strongly encourages biopsy for masses treated with ablation.…”

Section: Discussionmentioning

confidence: 82%

“…Trends were assessed based on reported primary treatment codes defining total nephrectomy (NCDB codes 40-50), partial nephrectomy (code 30), focal ablation (codes [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] or no surgery (code 00). Nephron sparing surgery included partial nephrectomy or a focal ablation procedure.…”

Section: Discussionmentioning

confidence: 99%

“…24 Another recent meta-analysis showed no significant difference in the metastasis rate among tumors managed by resection, ablation or surveillance, although followup in most underlying series remains relatively short. 25 A competing risk analysis in 1 large series demonstrated that in patients older than 75 years active intervention for clinically localized RCCs up to 7 cm had no impact on survival compared to surveillance. 26 Surveillance is endorsed by the guideline as a recommendation for patients with small masses and significant comorbidity, and as an option for those in better health.…”

Section: Discussionmentioning

confidence: 99%

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Treatment Trends for Stage I Renal Cell Carcinoma

et al. 2011

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Purpose: Renal cell carcinoma is increasingly diagnosed at stage I, and among stage I cases mean tumor size has been decreasing. Previous reports suggest that nephron sparing surgery is underused for small renal cell carcinomas. We determined updated, population based treatment trends for stage I renal cell carcinoma. Materials and Methods:The National Cancer Data Base, which captures approximately 70% of all cancer diagnoses in the United States, was queried for renal cell carcinoma in adults diagnosed between 1993 and 2007. Trends in treatment, including no surgery, total nephrectomy, partial nephrectomy and focal ablation, were analyzed among all stage I tumors and small stage I tumors categorized by size. Logistic regression was used to identify predictors of nephron sparing surgery (partial nephrectomy or focal ablation). Results: During the study period we identified 242,740 renal cell carcinomas, of which 127,691 were stage I. For all stage I tumors partial nephrectomy increased from 6.3% to 32.2% of cases and ablation increased from 1.0% to 6.8%. For tumors less than 2.0, 2.0 to 2.9 and 3.0 to 3.9 cm partial nephrectomy increased from 15.3% to 61.1%, 11.0% to 44.2% and 7.2% to 31.1%, respectively (each p Ͻ0.001). Female gender, black race, Hispanic ethnicity, lower income, older age and treatment at community hospitals were associated with lower use of nephron sparing. Conclusions: While total nephrectomy is still likely overused for small renal cell carcinoma, nephron sparing surgery for stage I renal cell carcinoma has increased substantially in the last 15 years with about 4-fold increases across tumor sizes. These trends appear to be ongoing but sociodemographic disparities exist which must be rectified.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Treatment Trends for Stage I Renal Cell Carcinoma

et al. 2011

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“…The incidence of benign SRMs according to ethnicity was various. The reported incidences of benign SRMs were 17.3%-23.4% in studies from Western countries [5,22,24,[26][27][28] and 7.1%-15.0% in studies from Asian countries [6,23,25]. In Asia, the incidence of benign SRMs is relatively low, because the incidence of oncocytoma is low [6].…”

Section: Discuissionmentioning

confidence: 99%

Growth kinetics of small renal mass: Initial analysis of active surveillance registry

Sw¹,

Lee²,

Lee³

et al. 2018

European Urology Supplements

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“…1 The incidence of RCC is increasing at 2% to 3% per year. 2 Over 70% of renal masses are diagnosed incidentally while still small in volume 3 with the standard of care being removal with a partial or radical nephrectomy. 4 Although most masses are found to be RCC on final histology, high proportions of benign disease have also been identified (up to 46% for small renal masses 5 ).…”

Section: Introductionmentioning

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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Pathological Features of Renal Neoplasms Classified by Size and Symptomatology

Cited by 115 publications

References 17 publications

Treatment Trends for Stage I Renal Cell Carcinoma

Treatment Trends for Stage I Renal Cell Carcinoma

Growth kinetics of small renal mass: Initial analysis of active surveillance registry

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

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