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The natural history and predictors for intervention in patients with small renal mass undergoing active surveillance.

Bahouth Z, Halachmi S, Meyer G, Avitan O, Moskovitz B, Nativ O - Adv Urol (2015)

Bottom Line: Methods.The mean follow-up period was 34 months (12-112).None of the patients developed metastases.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Bnai Zion Medical Center, 3339414 Haifa, Israel ; Faculty of Medicine, Technion-Israel Institute of Technology, 3200003 Haifa, Israel.

ABSTRACT
Aim. To describe the natural history of small renal mass on active surveillance and identify parameters that could help in predicting the need for intervention in patients with small renal masses undergoing active surveillance. We also discuss the need for renal biopsy in the management of these patients. Methods. A retrospective analysis of 78 renal masses ≤4 cm diagnosed at our Urology Department at Bnai Zion Medical Center between September 2003 and March 2012. Results. Seventy patients with 78 small renal masses were analyzed. The mean age at diagnosis was 68 years (47-89). The mean follow-up period was 34 months (12-112). In 54 of 78 masses there was a growth of at least 2 mm between imaging on last available follow-up and diagnosis. Eight of the 54 (15%) masses which grew in size underwent a nephron-sparing surgery, of which two were oncocytomas and six were renal cell carcinoma. Growth rate and mass diameter on diagnosis were significantly greater in the group of patients who underwent a surgery. Conclusions. Small renal masses might eventually be managed by active surveillance without compromising survival or surgical approach. All masses that were eventually excised underwent a nephron-sparing surgery. None of the patients developed metastases.

No MeSH data available.


Related in: MedlinePlus

Growth rate of small renal masses. Growth rate of masses that underwent active treatment was 0.53 cm/year (light line) which was significantly higher than that observed for masses which were managed expectantly, 0.12 cm/year (dark line). P < 0.0001.
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fig1: Growth rate of small renal masses. Growth rate of masses that underwent active treatment was 0.53 cm/year (light line) which was significantly higher than that observed for masses which were managed expectantly, 0.12 cm/year (dark line). P < 0.0001.

Mentions: We did a univariate and multivariate analysis to check for differences in patients' parameters in both groups. Univariate analysis showed size at diagnosis and tumor growth rate as the only parameters with significant difference. The mean growth rate of the lesions that were actively treated was 0.53 cm/year (95% CI 0.33, 0.71) as opposed to 0.12 cm/year (95% CI 0.08, 0.17) for masses managed expectantly (P < 0.0001) (Figure 1).


The natural history and predictors for intervention in patients with small renal mass undergoing active surveillance.

Bahouth Z, Halachmi S, Meyer G, Avitan O, Moskovitz B, Nativ O - Adv Urol (2015)

Growth rate of small renal masses. Growth rate of masses that underwent active treatment was 0.53 cm/year (light line) which was significantly higher than that observed for masses which were managed expectantly, 0.12 cm/year (dark line). P < 0.0001.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4413980&req=5

fig1: Growth rate of small renal masses. Growth rate of masses that underwent active treatment was 0.53 cm/year (light line) which was significantly higher than that observed for masses which were managed expectantly, 0.12 cm/year (dark line). P < 0.0001.
Mentions: We did a univariate and multivariate analysis to check for differences in patients' parameters in both groups. Univariate analysis showed size at diagnosis and tumor growth rate as the only parameters with significant difference. The mean growth rate of the lesions that were actively treated was 0.53 cm/year (95% CI 0.33, 0.71) as opposed to 0.12 cm/year (95% CI 0.08, 0.17) for masses managed expectantly (P < 0.0001) (Figure 1).

Bottom Line: Methods.The mean follow-up period was 34 months (12-112).None of the patients developed metastases.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Bnai Zion Medical Center, 3339414 Haifa, Israel ; Faculty of Medicine, Technion-Israel Institute of Technology, 3200003 Haifa, Israel.

ABSTRACT
Aim. To describe the natural history of small renal mass on active surveillance and identify parameters that could help in predicting the need for intervention in patients with small renal masses undergoing active surveillance. We also discuss the need for renal biopsy in the management of these patients. Methods. A retrospective analysis of 78 renal masses ≤4 cm diagnosed at our Urology Department at Bnai Zion Medical Center between September 2003 and March 2012. Results. Seventy patients with 78 small renal masses were analyzed. The mean age at diagnosis was 68 years (47-89). The mean follow-up period was 34 months (12-112). In 54 of 78 masses there was a growth of at least 2 mm between imaging on last available follow-up and diagnosis. Eight of the 54 (15%) masses which grew in size underwent a nephron-sparing surgery, of which two were oncocytomas and six were renal cell carcinoma. Growth rate and mass diameter on diagnosis were significantly greater in the group of patients who underwent a surgery. Conclusions. Small renal masses might eventually be managed by active surveillance without compromising survival or surgical approach. All masses that were eventually excised underwent a nephron-sparing surgery. None of the patients developed metastases.

No MeSH data available.


Related in: MedlinePlus