Liu Shuo, Lee Stephen, Rashid Prem, Bangash Haider, Hamid Akhlil, Lau Jason, Cohen Ronald
Royal Perth Hospital, Perth, WA, Australia.
Port Macquarie Base Hospital, Port Macquarie, NSW, Australia.
BJU Int. 2016 Oct;118 Suppl 3:30-34. doi: 10.1111/bju.13538. Epub 2016 Jul 26.
To evaluate the intermediate outcome of conservative management in patients with biopsy-proven oncocytoma.
Patients with oncocytoma diagnosed on percutaneous core biopsy between January 2000 to December 2014 were identified from the renal biopsy database of a large specialist urologic pathology laboratory. After review of patient clinical records, the study cohort comprised only of patients enrolled in active surveillance. Clinicopathological and follow-up details were reviewed for each case, in particular: type and interval of surveillance imaging, tumour growth, definitive intervention and reason for intervention. Where possible, correlation was made between the final surgical and the initial biopsy specimens.
Fifty three patients diagnosed with oncocytoma on core biopsy were initially placed on active surveillance with median follow-up of 34 months (range 6-109). The median age at diagnosis was 65 years (range 20-85) and median tumour size was 30 mm (range 13-87). Mean average tumour growth was 1.4 mm per annum (median 0 mm/year) with the majority (36 of 53, 68%) exhibiting minimal growth (less than 2 mm per annum) or partial regression. Forty seven of the 53 patients remained on active surveillance with no significant progression. Six patients elected to undergo definitive intervention (five surgical excision, one ablation). Renal oncocytoma was confirmed in all five patients who underwent surgical excision of their lesions.
The majority of oncocytomas in this study showed minimal growth rate or regression. Patients with biopsy proven oncocytoma can be conservatively managed with active surveillance.
评估经活检证实的肾嗜酸细胞瘤患者保守治疗的中期结果。
从一家大型专业泌尿外科病理实验室的肾活检数据库中,识别出2000年1月至2014年12月期间经皮穿刺活检确诊为肾嗜酸细胞瘤的患者。在查阅患者临床记录后,研究队列仅包括接受主动监测的患者。对每个病例的临床病理和随访细节进行了回顾,特别是:监测成像的类型和间隔、肿瘤生长情况、确定性干预措施及干预原因。在可能的情况下,对最终手术标本和初始活检标本进行了相关性分析。
53例经活检确诊为肾嗜酸细胞瘤的患者最初接受主动监测,中位随访时间为34个月(范围6 - 109个月)。诊断时的中位年龄为65岁(范围20 - 85岁),中位肿瘤大小为30毫米(范围13 - 87毫米)。平均肿瘤年生长率为1.4毫米(中位年生长率为0毫米),大多数患者(53例中的36例,68%)生长极小(每年小于2毫米)或部分消退。53例患者中有47例继续接受主动监测,无明显进展。6例患者选择进行确定性干预(5例手术切除,1例消融)。所有5例接受手术切除病变的患者均确诊为肾嗜酸细胞瘤。
本研究中的大多数肾嗜酸细胞瘤生长率极小或出现消退。经活检证实为肾嗜酸细胞瘤的患者可通过主动监测进行保守治疗。