Pathological heterogeneity in sporadic synchronous renal tumors: Is the histological concordance predictable?
| Autor: | Eric Fontaine, Sophie Hurel, Stéphane Richard, Thomas Le Guilchet, François Audenet, Virginie Verkarre, Marc-Olivier Timsit, Arnaud Mejean, Nicolas De Saint Aubert, A. Beaugerie, C. Delavaud, Jean-Michel Correas |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Pathology medicine.medical_specialty Urology Concordance 030232 urology & nephrology Age at diagnosis Genetic Heterogeneity 03 medical and health sciences 0302 clinical medicine Humans Medicine Carcinoma Renal Cell Pathological Univariate analysis business.industry Genetic heterogeneity Odds ratio Middle Aged Kidney Neoplasms Oncology 030220 oncology & carcinogenesis Female Radiology business Preoperative imaging |
| Zdroj: | Urologic Oncology: Seminars and Original Investigations. 36:11.e7-11.e12 |
| ISSN: | 1078-1439 |
| DOI: | 10.1016/j.urolonc.2017.09.002 |
| Popis: | To evaluate the pathological concordance rate of multiple synchronous renal masses (MSRM) presumed to be sporadic and to analyze predictive factors of concordance.We identified from our institutional database patients with sporadic MSRM treated at our center between January 2000 and December 2015. All tumors were reviewed by a dedicated uropathologist. Pathological concordance rate was analyzed regarding clinical characteristics and preoperative imaging.We included 112 patients: 50 had unilateral synchronous renal masses and 62 bilateral synchronous renal masses. A total of 291 tumors were analyzed, with an average of 2.6 tumors per patient. Overall, the malignant concordance rate was 91.6%, the pathological concordance rate was 67.3% and the grade concordance rate was 62.5%. In univariate analysis, predictive factors of histological concordance were bilateral synchronous renal masses (odds ratio [OR] = 3.39; 95% CI: 1.06-10.8; P = 0.04), age60 years (OR = 3.04; 95% CI: 1.2-7.7; P = 0.02) and ≥3 lesions (OR = 2.41; 95% CI: 1.03-5.68; P = 0.04). In multivariate analysis, age60 remained significantly associated with histological concordance (OR = 3.84; 95% CI: 1.24-11.9; P = 0.02).The histological concordance rate of MSRM is low. Age at diagnosis60 years, bilateral lesions and ≥3 tumors are predictive factors of histological concordance, but the pathological diagnosis remains difficult to predict. This heterogeneity is important to take into account, particularly when choosing the treatment upon the renal biopsy results from a single lesion. |
| Databáze: | OpenAIRE |
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