| Autor: |
van den Brink, Luna, Debelle, Tess, Gietelink, Lieke, Graafland, Niels, Ruiter, Annebeth, Bex, Axel, Beerlage, Harrie P., van Moorselaar, R. Jeroen A., Lagerveld, Brunolf, Zondervan, Patricia |
| Zdroj: |
Cancers; Oct2024, Vol. 16 Issue 20, p3518, 8p |
| Abstrakt: |
Simple Summary: In this national study, we found a low rate of 12% benign pathology after partial nephrectomy in the Netherlands. This raises the questions of whether we should aim to further reduce the rate of benign pathology, what rate is considered acceptable, and whether the more frequent use of renal tumor biopsies can contribute to this. We recommend that patients with clinical suspicion for renal cancer are discussed in multidisciplinary tumor board meetings to determine whether a biopsy could be of added value to avoid overtreatment. 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. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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