Real world outcomes of biopsy-proven oncocytic neoplasm of the kidney managed by surveillance.
Authors
Rodger, Flora E
Brown, Keiran
Leung, Steve
Coode-Bate, Jack
Armitage, James
Warren, Anne
Hendry, Jane
Publication Date
2022-07Journal Title
BJUI Compass
ISSN
2688-4526
Publisher
Wiley
Language
en
Type
Article
This Version
AO
VoR
Metadata
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Rodger, F. E., Brown, K., Leung, S., Coode-Bate, J., Armitage, J., Warren, A., Hendry, J., et al. (2022). Real world outcomes of biopsy-proven oncocytic neoplasm of the kidney managed by surveillance.. BJUI Compass https://doi.org/10.1002/bco2.141
Abstract
OBJECTIVES: To evaluate outcomes of patients diagnosed with oncocytic renal neoplasms on routine renal mass biopsy and to describe the natural history of these tumours when managed with surveillance as opposed to immediate intervention. To report disease-specific survival. PATIENTS AND METHODS: Patients were identified from a retrospective review of pathology databases from three tertiary referral centres that utilise renal mass biopsy in routine clinical practice. All patients with biopsy-proven oncocytic tumours were included and a retrospective review of online patient records was undertaken. RESULTS: There were 184 biopsy-proven oncocytic renal neoplasms identified in 172 patients. There were two biopsy complications (both pneumothorax, Clavien-Dindo Grade I). Of these lesions, 135 were reported as oncocytomas or oncocytic renal neoplasms that were not further classified and 37 were reported as chromophobe carcinoma (ChRCC). The median age at diagnosis was 70 (33-88). The average tumour diameter at diagnosis was 33 mm. One hundred seven tumours were initially managed with surveillance (including 13 ChRCC) with a minimum follow-up of 6 months and a median of 39 months (6-144) whereas 49 patients underwent immediate treatment. The mean growth rate across all oncocytic renal neoplasms managed by surveillance was 3 mm/year. There was no statistically significant difference in growth rates between oncocytic renal neoplasms and ChRCC. Thirteen patients with oncocytic renal neoplasms initially managed by surveillance moved on to an active management strategy during follow-up. The clinical indication given for a change from surveillance was tumour growth in 12 cases and patient choice in 1 case. Where definitive pathology was available, there was 85% concordance with the biopsy. There were no cases of development of metastatic disease or disease-related morbidity or mortality during the study. CONCLUSIONS: This multicentre retrospective cohort study supports the hypothesis that selected biopsy-proven oncocytic renal neoplasms can be safely managed with surveillance in the medium term. Routine renal mass biopsy may reduce surgery for benign or indolent renal tumours and the potential associated morbidity for these patients.
Keywords
ORIGINAL ARTICLE, ORIGINAL ARTICLES, biopsy, chromophobe carcinoma, oncocytic, oncocytoma, surveillance
Identifiers
bco2141
External DOI: https://doi.org/10.1002/bco2.141
This record's URL: https://www.repository.cam.ac.uk/handle/1810/334628
Rights
Licence:
http://creativecommons.org/licenses/by/4.0/
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