Association of hematuria on microscopic urinalysis and risk of urinary tract cancer

Abstract

Moreover, residual cancer cells may require many years to become clinically apparent, since the average annual growth rate of radiographically visible masses can be as small as 0.13 cm/year (3) with rare but real potential to metastases, leaving concerning to longer follow-up. While the benefits of nephron sparing surgery in terms of preventing chronic kidney disease and its associated cardiovascular morbidity and potential mortality are progressively clear (4,5), selection bias, variations in technique, tumor size and location make adequate evaluation of the enucleation and its comparison to standard partial nephrectomy difficult. Additionally, it is well recognized the phenomenon that despite increased detection and treatment of small tumors, mortality from RCC did not decrease (6), suggesting a lead time bias which uniquely joins kidney and prostate cancer; most patients will very likely die with their cancer rather than of their cancer. Further prospective, randomized and unbiased studies with technique standardization are necessary and advance in the identification of clinically significant tumors will be important in determining the renal masses needing treatment, as well as the well-adjusted treatment in each case. To the future, the answer needed is probably: when is enucleation necessary and safe?