NYU Langone Health, New York, NY.
NYU Langone Health, New York, NY.
Clin Genitourin Cancer. 2023 Jun;21(3):e114-e118. doi: 10.1016/j.clgc.2022.11.006. Epub 2022 Nov 18.
Over the past decade and a half, advances in diagnostic imaging as well as an increased utilization of active surveillance (AS) and renal mass biopsy (RMB) have led to an improved ability to identify benign lesions prior to partial nephrectomy (PN). We seek to examine the incidence of benign pathology at the time of PN in a contemporary cohort of patients undergoing PN for presumed renal cell carcinoma (RCC).
We performed a chart review on a prospectively maintained database on a series of patients who underwent PN between January 1, 2006 and December 31, 2021 for solid renal masses concerning for RCC.
One thousand two hundred twenty-nine patients were included in the analysis, with 240 patients (19.2%) identified to have benign disease on final pathology. Of patients with benign disease, (23%) of patients had angiomyolipoma (AML) and 64% had oncocytoma. Between 2006 and 2021, there was a significant increase in the incidence of benign pathology after PN. When examining 3-year rolling averages over this same time period, the incidence of oncocytoma appeared to increase while the incidence of AML decreased.
Despite improvements in diagnostic tools and increased utilization of active surveillance, the overall incidence of benign pathology, particularly oncocytoma, did not decrease over time in this contemporary cohort of patients undergoing PN.
在过去的十五年中,诊断成像技术的进步以及主动监测(AS)和肾肿瘤活检(RMB)的广泛应用,使得在部分肾切除术(PN)前识别良性病变的能力得到了提高。我们旨在检查在当代接受 PN 治疗疑似肾细胞癌(RCC)的患者人群中,PN 时良性病变的发生率。
我们对 2006 年 1 月 1 日至 2021 年 12 月 31 日期间接受 PN 治疗的一系列患有 RCC 相关实体肾肿块的患者的前瞻性维护数据库进行了图表回顾。
1229 名患者纳入分析,240 名(19.2%)患者最终病理诊断为良性疾病。良性疾病患者中,(23%)为血管平滑肌脂肪瘤(AML),64%为嗜酸细胞瘤。2006 年至 2021 年期间,PN 后良性病变的发生率显著增加。在同一时期检查 3 年滚动平均值时,似乎观察到嗜酸细胞瘤的发生率增加,而 AML 的发生率降低。
尽管诊断工具得到了改进,主动监测的应用也有所增加,但在本当代接受 PN 的患者人群中,良性病变的总体发生率(特别是嗜酸细胞瘤)并未随时间降低。