MP80-20 NATURAL HISTORY OF LARGE RENAL MASSES ON ACTIVE SURVEILLANCE: SYSTEMATIC REVIEW OF AVAILABLE CASE SERIES

Abstract

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging/Surveillance III (MP80)1 Apr 2020MP80-20 NATURAL HISTORY OF LARGE RENAL MASSES ON ACTIVE SURVEILLANCE: SYSTEMATIC REVIEW OF AVAILABLE CASE SERIES Kash Visram*, Adam Gabara, Naji Touma, and Francisco Vera Badillo Kash Visram*Kash Visram* More articles by this author , Adam GabaraAdam Gabara More articles by this author , Naji ToumaNaji Touma More articles by this author , and Francisco Vera BadilloFrancisco Vera Badillo More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000972.020AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Active surveillance for renal masses less than 4cm in size is a well-accepted management strategy in the older, comorbid patient. In contrast, little is known about the safety of active surveillance in renal masses larger than 4cm. The objective was to evaluate existing literature on active surveillance of large renal masses (>4cm), to determine the rate of intervention, metastatic rate, cancer specific mortality, and overall mortality. Additionally, tumor biology was evaluated using growth rate as a surrogate. METHODS: A comprehensive search of electronic databases (PUBMED, OVID, Cochane and Web of Science) using terms: “renal mass”, “kidney mass”, “nephrotic mass”, “renal tumor”, “kidney tumor”, “renal neoplasia”, “kidney neoplasia”, “renal neoplasm” and “kidney neoplasm” generated 19,475 studies. From this renal mass database, the terms “renal mass”, “surveillance”, “observation”, and “growth rate” provided 656 studies. These abstracts were reviewed by two independent trained reviewers and 628 studies were excluded. The remaining 28 papers underwent full text review and of these 6 studies met our inclusion criteria. This provided data on 295 large renal masses, from 285 patients, that were actively surveilled. The data from these papers underwent pooled analysis using weighted means to assess the outcomes of interest. A risk of bias assessment was also conducted. RESULTS: 295 large renal masses from 285 patients were identified. The mean age of these patients was 72.9 years. At presentation the mean size of the renal masses was 5.41cm and the mean surveillance time was 40.25 months. The mean linear growth rate of these masses was 0.568 cm/yr. 10.8% of large renal masses underwent a biopsy, and 7.28% underwent surgical interventions. 3.1% of masses progressed to metastatic disease. Cancer-specific mortality was 1.7%. Overall mortality was 7.46%. CONCLUSIONS: Large renal masses (> 4cm) appear to have a more aggressive cancer biology that their smaller counterparts (< 4cm) as reflected by a higher growth rate. However, metastatic rates and cancer specific mortality are low in carefully selected patients on active surveillance. Source of Funding: no sources to disclose © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1234-e1234 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kash Visram* More articles by this author Adam Gabara More articles by this author Naji Touma More articles by this author Francisco Vera Badillo More articles by this author Expand All Advertisement PDF downloadLoading ...