Kis méretű vesedaganatok patológiai és biológiai jellemzőinek elemzése a tumorméret alapján = Analysis of pathological and biological features of small renal masses based on the tumor size

Berczi, Csaba and Bacsó, Zsolt and Bidiga, László and Nagy, Judit and Flaskó, Tibor (2021) Kis méretű vesedaganatok patológiai és biológiai jellemzőinek elemzése a tumorméret alapján = Analysis of pathological and biological features of small renal masses based on the tumor size. ORVOSI HETILAP, 162 (42). pp. 1693-1697. ISSN 0030-6002

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Abstract

Introduction: The incidence of benign lesions is more common in small renal masses (SRMs) and biological behavior of small malignancies is better compared to larger ones.Objective: The authors measured the characteristics of SRMs in different subgroups.Method: From January 1, 2000 to January 1, 2015, 1272 patients underwent surgery for renal tumors. In 496 of the 1272 cases, the patients had SRMs. The mean age of the patients was 59 +/- 12 years. Based on the sizes, the SRMs were divided into three groups. The sizes of the renal tumors were <= 4 cm in Group 1, <= 3 cm in Group 2 and <= 2 cm in Group 3.Results: The mean diameter of the removed SRMs was 29 +/- 8 mm. Histology confirmed renal cell carcinoma in 418 cases (84%), while benign tumor was present in 78 patients (16%). However, with the tumor size <= 2 cm, malignancy was detected in 73.2% of the cases. There was a significant difference in the sizes of the malignant and the benign masses (p = 0.008). Grade 3 or 4 tumors were present in 10.8%, 14.4% and 20.7% when the tumor size was <= 2 cm, 2.1 to 3 cm, and 3.1 to 4 cm in diameter, respectively. During the mean 10-year follow-up period, tumor progression was detected only in 5.5% of malignancies.Conclusion: In 39% of all cases, the patients had SRMs. The majority of SRMs were malignant, and benign lesion occurred only in 16% of the cases. The incidence of malignant tumors was the lowest when the size of SRMs was <= 2 cm. The size of the tumor was highly associated with probability of malignancy and tumor grading. Based on the favorable pathological and biological results in tumors below 2 cm, active surveillance or minimally invasive treatment could be the preferred management.

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