Natural history of renal angiomyolipoma in a high-volume center: our experience during more than 15 years of follow up.

Autor: Aumatell, Júlia, Schwartzmann, Iván, Bravo-Balado, Alejandra, Subiela, José Daniel, Farré, Alba, Moncada, Enver, Martínez, María José, Palou, Joan, Breda, Alberto, Ponce de León Roca, Javier
Zdroj: International Urology & Nephrology; May2024, Vol. 56 Issue 5, p1551-1557, 7p
Abstrakt: Objectives: To describe the natural history of AML, the clinical results and the need for treatment during long-term follow-up of renal AML. Methods: Retrospective study of patients diagnosed with AML by computed tomography or nuclear magnetic resonance between 2001 and 2019, with at least two follow-up images. Clinical and imaging variables, need for intervention, complications and follow-up time were recorded. Statistical analysis was performed using SPSS 22.0. Results: 111 patients and 145 AML were included. The median follow-up was 6.17 years (range 0.7–18.1, IQR 11.8–12.2). The median tumor size at diagnosis was 13 mm (IQR 7.5–30), with 24 (16.4%) being ≥ 4 cm. Most presented as an incidental finding (85.5%); in 3 (2.1%) cases, the presentation was as a spontaneous retroperitoneal hematoma. The main indication for intervention was size ≥ 4 cm in 50%. Eighteen (12%) patients received a first intervention, being urgent in 3. Embolization was performed in 15 cases and partial nephrectomy in 3. The need for reintervention was recorded in five: two underwent partial nephrectomy and two total nephrectomy; one patient required a new urgent embolization. Of the non-operated patients, 43% decreased in size or did not change, while 57% increased, with the median annual growth being 0.13 mm (IQR − 0.11 to 0.73). There were no differences in the median growth in tumors measuring ≥ 4 cm (0.16 mm) at diagnosis vs. < 4 cm (0.13 mm) (p = 0.9). Conclusions: The findings of this study suggest that AML typically demonstrate a slow-progressing clinical course during long-term follow-up. Moreover, our observations, which cast doubt on tumor size as a reliable predictor of adverse clinical outcomes, advocate for a less intensive monitoring strategy in both monitoring frequency and choice of imaging modality. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
Externí odkaz: