| Autor: |
van den Brink L; Department of Urology, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.; Department of Urology, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands.; Cancer Center Amsterdam, Imaging and Biomarkers, 1081 HV Amsterdam, The Netherlands., Debelle T; Department of Urology, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands., Gietelink L; Department of Urology, Spaarne Gasthuis, 2035 RC Haarlem, The Netherlands., Graafland N; Department of Urology, Netherlands Cancer Institute (NKI), 1066 CX Amsterdam, The Netherlands., Ruiter A; Department of Urology, OLVG, 1091 AC Amsterdam, The Netherlands., Bex A; Department of Urology, Netherlands Cancer Institute (NKI), 1066 CX Amsterdam, The Netherlands.; Department of Urology, Royal Free Hospital, London NW3 2QG, UK., Beerlage HP; Department of Urology, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands., van Moorselaar RJA; Department of Urology, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands., Lagerveld B; Department of Urology, OLVG, 1091 AC Amsterdam, The Netherlands., Zondervan P; Department of Urology, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands. |
| Abstrakt: |
Objectives : To determine the rate of benign pathology in cT1 tumors following partial nephrectomy in the Netherlands, thereby evaluating the rate of overtreatment. Methods: Data were collected from a nationwide database containing histopathology of resected renal tissue from 2014 to 2022. Patients who underwent partial nephrectomy for suspected RCC staged T1a-b were extracted for analysis. Data are shown in percentages, and multivariable logistic regression was performed to determine predictive factors for benign pathology. Results : 3409 cases were analyzed, of which 403 (12%) were benign and 3006 (88%) malignant. Subtype analysis showed 2126 (62%) cases of clear-cell RCC, followed by 604 (18%) of papillary RCC and 344 (10%) oncocytomas. Mean age was 63 years among patients with malignant pathology versus 65 years for patients with benign lesions ( p < 0.001). Mean tumor size was 3.2 cm for malignant pathology and 2.9 cm for benign ( p < 0.001). The rates of benign and malignant pathology did not change between 2014 and 2022 ( p = 0.377). Multivariable regression showed age ≥ 65 years (65-79 years [OR 1.881, p = 0.002], ≥ 80 years [OR 3.642, p < 0.001]) and tumor size (OR 0.793, p < 0.001) as predictors for benign pathology. The main limitation of this study is that we do not know the biopsy rate of our cohort. Conclusion: This study reports a low rate of 12% benign pathology after partial nephrectomy in the Netherlands. It remains debatable whether these rates are acceptable, or if renal tumor biopsies should be utilized more frequently to reduce overtreatment. |
