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Urol Oncol. 2018 Aug;36(8):362.e9-362.e15. doi: 10.1016/j.urolonc.2018.05.001. Epub 2018 Jun 1.

Declining incidence of benign lesions among small renal masses treated with surgery: Effect of diagnostic tests for characterization.

Author information

1
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; Department of Urology, Seoul National University Boramae Medical Center, Seoul, Korea.
2
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
3
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Electronic address: igjeong@amc.seoul.kr.

Abstract

PURPOSE:

We evaluated the changes in the incidence of benign lesions in surgically removed small renal masses (SRMs) and the effect of diagnostic tests for characterizing SRMs.

METHODS:

We included 2,707 patients receiving surgery for SRMs (<4cm). Trends in the incidence of benign histology were evaluated according to the surgery year (period 1: 2001-2005, 2: 2006-2010, and 3: 2011-2015). Multivariable logistic regression analysis was performed to identify factors associated with benign lesions. Additionally, the number of surgeries prevented due to benign histological findings on renal mass biopsies (RMB) done on 206 patients with SRM during study period was evaluated.

RESULTS:

Benign histology was identified in 192 (7.1%) patients. Incidence of benign histology was 9.7%, 7.0%, and 6.3% for period 1, 2 and 3, respectively. The uses of multiphase computed tomography and magnetic resonance imaging were more common in periods 2 and 3 than in period 1 (P<0.001). The use of RMB in period 3 was higher than in periods 1 and 2 (0.8 vs. 0.9 vs. 9.0%, P<0.001). In multivariable analysis, older age, male sex, larger tumor size, and recent surgery year (period 3 vs. 1, odds ratio = 0.62, P = 0.028) were independently associated with decreased odds of benign lesions. The number of prevented surgeries by performing RMB was 0, 10, and 39 in periods 1, 2, and 3, respectively.

CONCLUSIONS:

Incidence of benign histology after surgery for SRMs declined during recent years, which might be associated with the recent increased use of RMB.

KEYWORDS:

Carcinoma, Renal cell; Diagnosis; Incidence; Nephrectomy

PMID:
29866577
DOI:
10.1016/j.urolonc.2018.05.001
[Indexed for MEDLINE]

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