Ameri Carlos Alberto, Pita Hernando Rios, Vitagliano Gonzalo, Blas Leandro
Hospital Aleman de Buenos Aires, Buenos Aires, Argentina.
Turk J Urol. 2021 Jan;47(1):9-13. doi: 10.5152/tud.2020.20201. Epub 2020 Oct 9.
Most of the studies regarding natural history of renal masses are based on active surveillance series and suggest that the renal masses have a slow growth rate. Nevertheless, only a few studies report the time between a normal computed tomography (CT) scan to the first detection of a tumor. We aimed to analyze the growth rate in newly diagnosed kidney tumors.
We analyzed patients with enhancing renal masses that developed after a normal CT scan, which was performed at most 12 months earlier. Variables examined included patient age, gender, tumor size, volume, tumor linear growth rate (LGR). All cases were surgically treated. Mann-Whitney U test was used to compare variables. A p<0.05 was considered as statistically significant.
We found 31 patients with 33 lesions. Male to female ratio was 1.58 (19/12). The average age was 59.2 years (standard deviation [SD]±12.1), and the mean tumor size was 4.27 cm (SD±4.3). Tumor LGR was 0.87 cm/month (range: 0.28-1.66) and presumed to be 10.4 cm at 1 year (range: 3.36-19.9). Tumor LGR for time detection at <6 month or ≥6 months were 1.1 cm/month and 0.68 cm/month (range: 0.27-1.08 and 0.88-1.76, respectively; p=0.0004), respectively. Tumor LGRs for low- and high-grade tumors were 0.89 cm/month and 0.83 cm/month (p=0.65), respectively. Median volume was 36.1 cm (range: 2.61-143.7), and for low and high grade the median volumes were 27.9 cm and 47.6 cm, respectively (p=0.54). Malignant pathology was present in 93.9 % (31 of 33) of masses (lesions).
We found differences in tumor LGR in tumors detected before and after 6 months. We did not find any correlation between tumor growth rate and Fuhrman grade system, gender, histology, or age. We found the highest LGR published up to date.
大多数关于肾肿块自然病史的研究基于主动监测系列，并表明肾肿块生长速度缓慢。然而，只有少数研究报告了从正常计算机断层扫描（CT）到首次发现肿瘤的时间间隔。我们旨在分析新诊断肾肿瘤的生长速度。
我们分析了在最多12个月前进行的正常CT扫描后出现的强化肾肿块患者。检查的变量包括患者年龄、性别、肿瘤大小、体积、肿瘤线性生长率（LGR）。所有病例均接受手术治疗。采用Mann-Whitney U检验比较变量。p<0.05被认为具有统计学意义。
我们发现31例患者有33个病灶。男女比例为1.58（19/12）。平均年龄为59.2岁（标准差[SD]±12.1），平均肿瘤大小为4.27 cm（SD±4.3）。肿瘤LGR为0.87 cm/月（范围：0.28 - 1.66），预计1年后为10.4 cm（范围：3.36 - 19.9）。在<6个月或≥6个月时检测到肿瘤的LGR分别为1.1 cm/月和0.68 cm/月（范围分别为0.27 - 1.08和0.88 - 1.76；p = 0.0004）。低级别和高级别肿瘤的LGR分别为0.89 cm/月和0.83 cm/月（p = 0.65）。中位体积为36.1 cm（范围：2.61 - 143.7），低级别和高级别肿瘤的中位体积分别为27.9 cm和47.6 cm（p = 0.54）。93.9%（33个病灶中的31个）的肿块（病灶）存在恶性病理。
我们发现6个月前后检测到的肿瘤在LGR上存在差异。我们未发现肿瘤生长速度与Fuhrman分级系统、性别、组织学或年龄之间存在任何相关性。我们发现了迄今为止公布的最高LGR。
