Cystic Renal Cell Carcinoma: A Report on Outcomes of Surgery and Active Surveillance in Patients Retrospectively Identified on Pretreatment Imaging
| Autor: | Maria F. Becerra, Michael Chiok, Alejandro Sanchez, Mazyar Ghanaat, Andreas M. Hötker, Satish K. Tickoo, Kyle A. Blum, Paul Russo, Jozefina Casuscelli, A. Ari Hakimi, Renzo G. DiNatale, Brandon J. Manley, Oguz Akin, Mahyar Kashan, Cihan Duzgol, Jonathan A. Coleman |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Urology medicine.medical_treatment 030232 urology & nephrology Kidney Nephrectomy 03 medical and health sciences 0302 clinical medicine Interquartile range Renal cell carcinoma medicine Carcinoma Humans Watchful Waiting Carcinoma Renal Cell Retrospective Studies business.industry Kidney Diseases Cystic Middle Aged Prognosis medicine.disease Kidney Neoplasms Clear cell renal cell carcinoma Treatment Outcome medicine.anatomical_structure 030220 oncology & carcinogenesis Cohort Female Radiology Neoplasm Recurrence Local Tomography X-Ray Computed business Watchful waiting Follow-Up Studies |
| Zdroj: | Journal of Urology. 200:275-282 |
| ISSN: | 1527-3792 0022-5347 |
| DOI: | 10.1016/j.juro.2018.02.3087 |
| Popis: | We evaluated the outcomes of surgical intervention and active surveillance in patients diagnosed with cystic renal cell carcinoma at our hypothesized radiological cutoff of greater than 50% cystic.We identified all 430 patients with a pathologically confirmed cystic renal mass that fit our criteria from 2000 to 2015. The 292 patients with a lack of computerized tomography, tumors less than 50% cystic on imaging, multifocal tumors and prior renal cell carcinoma were excluded from study. Patients were stratified into benign or malignant subgroups, and radiological, clinicopathological and oncologic features were determined. Univariate and multivariate associations between clinicoradiological parameters in each group were analyzed. We similarly reviewed the records of a separate cohort of patients treated with active surveillance for cystic renal cell carcinoma.Of the 138 identified cases of cystic renal cell carcinoma 102 (73.9%) were renal cell carcinoma and 36 (26.1%) were benign masses. Of the tumors 77.5% were Fuhrman grade 1-2, 83.4% were stage pT2 or less and 65.9% showed clear cell histology. On univariate analysis male gender, a solid component and increasing Bosniak classification were significant for malignancy. In a separate cohort we identified 38 patients on active surveillance. The growth rate was 1.0 mm per year overall and 2.3 mm per year for the solid component. At a median followup of more than 4 years in all cohorts there was no evidence of recurrence or metastasis of cystic renal cell carcinoma.Patients with unifocal cystic renal cell carcinoma evaluated using a standardized radiological threshold of greater than 50% cystic had an excellent prognosis on active surveillance and after surgical resection. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|