Is anatomic complexity associated with renal tumor growth kinetics under active surveillance?

Urologic Oncology
Reza MehrazinRobert G Uzzo

Abstract

Linear growth rate (LGR) is the most commonly employed trigger for definitive intervention in patients with renal masses managed with an initial period of active surveillance (AS). Using our institutional cohort, we explored the association between tumor anatomic complexity at presentation and LGR in patients managed with AS. Enhancing renal masses managed expectantly for at least 6 months were included for analysis. The association between Nephrometry Score and LGR was assessed using generalized estimating equations, adjusting for the age, Charlson score, race, sex, and initial tumor size. Overall, 346 patients (401 masses) met the inclusion criteria (18% ≥ cT1b), with a median follow-up of 37 months (range: 6-169). Of these, 44% patients showed progression to definitive intervention with a median duration of 27 months (range: 6-130). On comparing patients managed expectantly to those requiring intervention, no difference was seen in median tumor size at presentation (2.2 vs. 2.2 cm), whereas significant differences in median age (74 vs. 65 y, P < 0.001), Charlson comorbidity score (3 vs. 2, P<0.001), and average LGR (0.23 vs. 0.49 cm/y, P < 0.001) were observed between groups. Following adjustment, for each 1-point increase i...Continue Reading

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Mar 20, 2014·The Journal of Urology·Reza MehrazinRobert G Uzzo

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Citations

Dec 15, 2015·The Journal of Urology·Nikhil Waingankar, Robert G Uzzo
Feb 20, 2016·Future Oncology·Fatima Z HusainReza Mehrazin
Sep 1, 2015·Lancet·Umberto Capitanio, Francesco Montorsi
Jun 21, 2016·International Journal of Surgery·Alessandro Volpe
Apr 27, 2018·Current Opinion in Urology·Jaime O Herrera-Caceres, Michael A S Jewett
Jun 5, 2016·Current Opinion in Urology·Gregory A JoiceMohamad E Allaf
May 26, 2017·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·J J GriffithR Mehrazin
Aug 15, 2018·Current Urology Reports·Christine W LiawReza Mehrazin

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