Azizi Behrooz, Whelan Thomas, Morse Michael
St George's University School of Medicine, Grenada.
Can J Urol. 2009 Dec;16(6):4921-3.
To determine the incidence of malignancy in resected renal tumors in a subpopulation of Canadian patients and the significance of tumor size, patient's demographics, and whether the tumor was an incidental finding.
Medical records of 168 consecutive nephrectomies performed between March 2003 and June 2008 at our institution were reviewed retrospectively.
Average age of the patients was 61 years old (SD 11, range 28-89) and male to female ratio was 1.3:1. Total of 180 masses were resected in 168 nephrectomies (128 radical, 40 partial) during the study period. Of the 180 masses, 20 (11%) were benign and 160 (89%) were malignant lesions. Fifty-five percent of the resected renal masses were incidentally found on preoperative imaging. Based on the pathology reports, the average size of the masses was 5.5 cm (SD 4.0, range 0.3-25.0). The larger masses were more likely to be malignant than the smaller masses (Pearson's chi-square test, p = 0.040).
The present study assists us to adequately assess the risk of malignancy of a renal mass in a Canadian population based on size which allows us to properly advise the patients and suggest best possible treatment options. We recommend more aggressive therapies for masses larger than 4 cm and parenchymal sparing procedures for masses smaller than 4 cm as large proportion of these are benign.
确定加拿大患者亚群体中切除的肾肿瘤的恶性发生率，以及肿瘤大小、患者人口统计学特征的意义，以及肿瘤是否为偶然发现。
回顾性分析2003年3月至2008年6月在我们机构连续进行的168例肾切除术的病历。
患者的平均年龄为61岁（标准差11，范围28 - 89岁），男女比例为1.3:1。在研究期间，168例肾切除术中共切除了180个肿块（128例根治性，40例部分性）。在这180个肿块中，20个（11%）为良性，160个（89%）为恶性病变。55%的切除肾肿块是在术前影像学检查中偶然发现的。根据病理报告，肿块的平均大小为5.5厘米（标准差4.0，范围0.3 - 25.0厘米）。较大的肿块比较小的肿块更有可能是恶性的（Pearson卡方检验，p = 0.040）。
本研究有助于我们根据大小充分评估加拿大人群中肾肿块的恶性风险，这使我们能够适当地为患者提供建议并提出最佳的治疗方案。我们建议对大于4厘米的肿块采用更积极的治疗方法，对小于4厘米的肿块采用保留肾实质的手术，因为其中很大一部分是良性的。
