Abstract
INTRODUCTION AND OBJECTIVES
Growth trajectory as assessed by change in size on cross-sectional imaging is considered as a surrogate marker for malignancy and aggressiveness in small renal masses (SRMs). This remains poorly understood, however. The study was aimed at finding out factors which can influence growth of SRMs in patients opting for active surveillance in a population of a region in the United Kingdom.
METHODS
A population based study using cross-linked methodology of healthcare data. 248 consecutive patients diagnosed with SRMs between January 2007 and December 2014 opting for active surveillance following discussions in multidisciplinary meetings were recruited into this study. Patients were followed up using imaging at intervals of 6-12 months and progression was recorded after review at multidisciplinary meeting by uro-radiologists. A number of factors were evaluated as predictors of growth (increase in tumour size) including age, gender, Scottish Index of Multiple Deprivation (SIMD), initial presentation (symptomatic vs asymptomatic), charlson index (co-morbidities), location of SRMs (peripheral versus central), multiplicity, and baseline eGFR. Univariate and multivariate analyses were carried out to assess the best predictor/s of tumour growth, using conventional statistical tests at level of p value<0.05.
RESULTS
Mean age of the cohort was 68.4 (+/-13.5) with more than half were males 140 (56.5%). Eighty one (32.7%) cases showed progression in tumour size and 5 cases (2.0%) metastasized. Our multivariate analyses have shown that lower eGFR at baseline (within 3 months of diagnosis), co-morbidity and tumour location were independently associated with increase in tumour growth.
CONCLUSIONS
Co-morbidity, location of tumour and lower estimated glomerular filtration rate at the time of diagnosis were associated with significant progression in size of small renal masses during surveillance period. These factors should be kept in mind while making decisions in the management of this condition.
Growth trajectory as assessed by change in size on cross-sectional imaging is considered as a surrogate marker for malignancy and aggressiveness in small renal masses (SRMs). This remains poorly understood, however. The study was aimed at finding out factors which can influence growth of SRMs in patients opting for active surveillance in a population of a region in the United Kingdom.
METHODS
A population based study using cross-linked methodology of healthcare data. 248 consecutive patients diagnosed with SRMs between January 2007 and December 2014 opting for active surveillance following discussions in multidisciplinary meetings were recruited into this study. Patients were followed up using imaging at intervals of 6-12 months and progression was recorded after review at multidisciplinary meeting by uro-radiologists. A number of factors were evaluated as predictors of growth (increase in tumour size) including age, gender, Scottish Index of Multiple Deprivation (SIMD), initial presentation (symptomatic vs asymptomatic), charlson index (co-morbidities), location of SRMs (peripheral versus central), multiplicity, and baseline eGFR. Univariate and multivariate analyses were carried out to assess the best predictor/s of tumour growth, using conventional statistical tests at level of p value<0.05.
RESULTS
Mean age of the cohort was 68.4 (+/-13.5) with more than half were males 140 (56.5%). Eighty one (32.7%) cases showed progression in tumour size and 5 cases (2.0%) metastasized. Our multivariate analyses have shown that lower eGFR at baseline (within 3 months of diagnosis), co-morbidity and tumour location were independently associated with increase in tumour growth.
CONCLUSIONS
Co-morbidity, location of tumour and lower estimated glomerular filtration rate at the time of diagnosis were associated with significant progression in size of small renal masses during surveillance period. These factors should be kept in mind while making decisions in the management of this condition.
| Original language | English |
|---|---|
| Pages (from-to) | e1126-e1127 |
| Number of pages | 2 |
| Journal | Journal of Urology |
| Volume | 195 |
| Issue number | 4 Supplement |
| DOIs | |
| Publication status | Published - Apr 2016 |
| Externally published | Yes |
| Event | American Urological Association - Duration: 1 May 2016 → … |