Tumour location as a predictor of benign disease in the management of renal masses.

OBJECTIVE

To investigate the association between tumour location and the proportion of benign disease in renal masses presumed to be renal cell carcinoma (RCC) preoperatively.

METHODS

This Institutional Review Board approved study includes 196 patients who underwent surgical treatment for renal masses <5 cm at our institution by a single surgeon between January 2002 and June 2009. Based on preoperative imaging, each mass was designated as central (touching or encroaching upon the renal collecting system and/or renal sinus) or peripheral. The association between tumour location and benign pathology was determined using univariate and multiple logistic regression, including tumour size and patient sex in the model.

RESULTS

The proportion of histologically confirmed benign disease in this series was 11.2%. The proportion of benign disease by location was 5.9% and 19.5% for central and peripheral masses, respectively. The effect of location was found to have a significant prognostic value (p = 0.0273) with an adjusted odds ratio of 3.51 (95% CI = 1.38-19.62) for the odds of a benign diagnosis in peripheral compared to central tumours. Tumour size and patient sex were not significant predictors of benign pathology (p = 0.483 and 0.191, respectively).

CONCLUSIONS

Peripherally located renal masses are more likely to be benign than centrally located renal masses. This information may be used when selecting strategies for the management of renal masses presumed to be RCC.