Comparative Analysis of Surgery, Thermal Ablation, and Active Surveillance for Renal Oncocytic Neoplasms.
Urology
; 112: 92-97, 2018 Feb.
Article
in En
| MEDLINE
| ID: mdl-29030073
ABSTRACT
OBJECTIVE:
To compare oncological and procedural outcomes for renal oncocytic tumors treated with surgery, thermal ablation, or active surveillance.METHODS:
Clinical and pathologic data were collected for consecutive patients with a histologic diagnosis of oncocytoma, oncocytic neoplasm, or chromophobe renal cell cancer (chRCC) from 2003 to 2016. Independent pathology and radiology reviews were performed for this study.RESULTS:
Of 171 patients, tumor histology included oncocytoma (n = 122), chRCC (n = 47), and oncocytic neoplasm not otherwise specified (n = 2). At the initial diagnosis, 67, 14, and 90 patients were treated with surgery, thermal ablation, and active surveillance. In 3 of 19 patients (16%) who had biopsy and subsequent surgery, diagnosis changed from oncocytoma to chRCC. The median follow-up was 39.9 months with no difference among choices of treatment modalities (P = .33). Of 90 patients who began active surveillance, 32 (36%) switched to active treatments (19 underwent thermal ablation and 13 underwent surgery). The median linear growth rate for patients on active surveillance was 1.2 mm/y. No patients who were managed with active surveillance developed metastatic renal cell cancer (mRCC). mRCC was identified in 3 patients and was the cause of death in 2 patients. Patients who developed metastatic disease presented with symptomatic tumors of >4 cm and were treated with immediate surgery. For oncocytic masses of ≤4 cm (n = 126), the 5-year cancer-specific survival was 100%.CONCLUSION:
Renal oncocytic neoplasms have favorable oncological outcomes. Active surveillance is safe and is the preferred management for small (≤4 cm) oncocytic renal tumors in selected patients.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Carcinoma, Renal Cell
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Adenoma, Oxyphilic
/
Ablation Techniques
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Watchful Waiting
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Kidney Neoplasms
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Nephrectomy
Type of study:
Observational_studies
/
Screening_studies
Limits:
Adult
/
Aged
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Female
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Humans
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Male
/
Middle aged
Language:
En
Journal:
Urology
Year:
2018
Document type:
Article