Small renal masses in Latin-American population

To evaluate demographic, clinical and pathological characteristics of small renal masses (SRM) (≤ 4 cm) in a Latin-American population provided by LARCG (Latin-American Renal Cancer Group) and analyze predictors of survival, recurrence and metastasis. A multi-institutional retrospective cohort study...

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Detalles Bibliográficos
Autores: Mourão, T.C.|||0000-0003-4800-6009, Abreu, Diego|||0000-0001-8232-5092, Carvalhal, Gustavo Franco, Gueglio, Guillermo M., da Costa, Walter Henriques|||0000-0002-2940-4995, Calsavara, Vinicius Fernando, Meza-Montoya, Luis, Bengió, Rúben Guillermo, Scorticati, Carlos H., Castillejos-Molina, Ricardo Alonso, Rodriguez-Covarrubias, Francisco|||0000-0003-0056-7886, Autran Gómez, Ana María|||0000-0002-4961-5669, Campos-Salcedo, José Gadú, Nolazco, Alejandro, Ameri, Carlos Alberto, Zampolli, Hamilton De Campos, Langenhin, Raúl, Muguruza, Diego, Tobias-Machado, Marcos, Mingote, Pablo|||0000-0003-0693-1255, Clavijo, Jorge, Nogueira, Lucas Mendes|||0000-0002-3612-6524, Clark, Omar, Rovegno, Agustín Roberto, Secín, Fernando Pablo, Decia, Ricardo, Cardoso Guimarães, Gustavo|||0000-0002-1317-2114, Glina, Sidney|||0000-0002-9053-5046, Rodríguez Faba, Óscar|||0000-0001-6668-4423, Palou, Juan|||0000-0003-1264-5327, Zequi, Stênio de Cássio|||0000-0003-1897-8085
Tipo de recurso: artículo
Fecha de publicación:2020
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:284135
Acceso en línea:https://ddd.uab.cat/record/284135
https://dx.doi.org/urn:doi:10.1186/s12894-020-00649-8
Access Level:acceso abierto
Palabra clave:Kidney cancer
Latin America
Nephrectomy
Nephron-sparing surgery
Renal cell carcinoma
Descripción
Sumario:To evaluate demographic, clinical and pathological characteristics of small renal masses (SRM) (≤ 4 cm) in a Latin-American population provided by LARCG (Latin-American Renal Cancer Group) and analyze predictors of survival, recurrence and metastasis. A multi-institutional retrospective cohort study of 1523 patients submitted to surgical treatment for non-metastatic SRM from 1979 to 2016. Comparisons between radical (RN) or partial nephrectomy (PN) and young or elderly patients were performed. Kaplan-Meier curves and log-rank tests estimated 10-year overall survival. Predictors of local recurrence or metastasis were analyzed by a multivariable logistic regression model. PN and RN were performed in 897 (66%) and 461 (34%) patients. A proportional increase of PN cases from 48.5% (1979-2009) to 75% (after 2009) was evidenced. Stratifying by age, elderly patients (≥ 65 years) had better 10-year OS rates when submitted to PN (83.5%), than RN (54.5%), p = 0.044. This disparity was not evidenced in younger patients. On multivariable model, bilaterality, extracapsular extension and ASA (American Society of Anesthesiologists) classification ≥3 were predictors of local recurrence. We did not identify significant predictors for distant metastasis in our series. PN is performed in Latin-America in a similar proportion to developed areas and it has been increasing in the last years. Even in elderly individuals, if good functional status, sufficiently fit to surgery, and favorable tumor characteristics, they should be encouraged to perform PN. Intending to an earlier diagnosis of recurrence or distant metastasis, SRM cases with unfavorable characteristics should have a more rigorous follow-up routine.

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