Predictors of growth kinetics and outcomes in small renal masses (SRM ≤4 cm in size)

Tayside Active Surveillance Cohort (TASC) Study

C. Paterson, C. Yew-Fung, C. Sweeney, M. Szewczyk-Bieda, S. Lang, G. Nabi

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective To determine outcomes of small renal masses (≤4 cm) on active surveillance and explore factors which can influence their growth. Patients and methods Two hundred twenty six patients between January 2007 and December 2014 were analysed using cross-linked methodology of healthcare data and independent review. Cancer specific and non-specific survival were the primary outcomes. Growth kinetics, factors influencing growth and need for interventions were secondary outcomes. Results 101 (64.4%) solid and 4 (5.9%) cystic SRMs showed growth. 43 (19.02%) of SRMs required treatment interventions. Seven patients (7/158; 4.4%) died due to renal cancer at a median follow-up of 21.7 (SD 10.6, min 6–42) months, all in solid category. Independent review of serial radiological imaging of these seven cases showed two patients had subtle metastatic disease at the initial presentation, and 5 of the 7 did not adhere to recommended imaging regime. 33 (33/158; 20.8%) died due to other causes including non-renal cancers (14/158; 8.8%). Multivariate analyses showed that lower eGFR at baseline, co-morbidities and tumour location were independently associated with growth in size. Conclusions A higher cancer-specific mortality was seen in the present study compared to the reported literature. Independent critical review of imaging of cases with poor outcome underscored the importance of adherence to a robust protocol including follow up. Comorbid conditions had a significant impact on growth and overall survival of patients with SRMs.

Original languageEnglish
Pages (from-to)1589-1597
Number of pages9
JournalEuropean Journal of Surgical Oncology
Volume43
Issue number8
DOIs
Publication statusPublished - 1 Aug 2017
Externally publishedYes

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Cohort Studies
Kidney
Growth
Neoplasms
Survival
Kidney Neoplasms
Intercellular Signaling Peptides and Proteins
Multivariate Analysis
Morbidity
Delivery of Health Care
Mortality
Therapeutics

Cite this

@article{471ebdce249c4dbd84050ca8bce89666,
title = "Predictors of growth kinetics and outcomes in small renal masses (SRM ≤4 cm in size): Tayside Active Surveillance Cohort (TASC) Study",
abstract = "Objective To determine outcomes of small renal masses (≤4 cm) on active surveillance and explore factors which can influence their growth. Patients and methods Two hundred twenty six patients between January 2007 and December 2014 were analysed using cross-linked methodology of healthcare data and independent review. Cancer specific and non-specific survival were the primary outcomes. Growth kinetics, factors influencing growth and need for interventions were secondary outcomes. Results 101 (64.4{\%}) solid and 4 (5.9{\%}) cystic SRMs showed growth. 43 (19.02{\%}) of SRMs required treatment interventions. Seven patients (7/158; 4.4{\%}) died due to renal cancer at a median follow-up of 21.7 (SD 10.6, min 6–42) months, all in solid category. Independent review of serial radiological imaging of these seven cases showed two patients had subtle metastatic disease at the initial presentation, and 5 of the 7 did not adhere to recommended imaging regime. 33 (33/158; 20.8{\%}) died due to other causes including non-renal cancers (14/158; 8.8{\%}). Multivariate analyses showed that lower eGFR at baseline, co-morbidities and tumour location were independently associated with growth in size. Conclusions A higher cancer-specific mortality was seen in the present study compared to the reported literature. Independent critical review of imaging of cases with poor outcome underscored the importance of adherence to a robust protocol including follow up. Comorbid conditions had a significant impact on growth and overall survival of patients with SRMs.",
keywords = "Active surveillance, Co-morbidities, Growth patterns, Outcomes, Small renal masses",
author = "C. Paterson and C. Yew-Fung and C. Sweeney and M. Szewczyk-Bieda and S. Lang and G. Nabi",
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Predictors of growth kinetics and outcomes in small renal masses (SRM ≤4 cm in size) : Tayside Active Surveillance Cohort (TASC) Study. / Paterson, C.; Yew-Fung, C.; Sweeney, C.; Szewczyk-Bieda, M.; Lang, S.; Nabi, G.

In: European Journal of Surgical Oncology, Vol. 43, No. 8, 01.08.2017, p. 1589-1597.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Predictors of growth kinetics and outcomes in small renal masses (SRM ≤4 cm in size)

T2 - Tayside Active Surveillance Cohort (TASC) Study

AU - Paterson, C.

AU - Yew-Fung, C.

AU - Sweeney, C.

AU - Szewczyk-Bieda, M.

AU - Lang, S.

AU - Nabi, G.

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Objective To determine outcomes of small renal masses (≤4 cm) on active surveillance and explore factors which can influence their growth. Patients and methods Two hundred twenty six patients between January 2007 and December 2014 were analysed using cross-linked methodology of healthcare data and independent review. Cancer specific and non-specific survival were the primary outcomes. Growth kinetics, factors influencing growth and need for interventions were secondary outcomes. Results 101 (64.4%) solid and 4 (5.9%) cystic SRMs showed growth. 43 (19.02%) of SRMs required treatment interventions. Seven patients (7/158; 4.4%) died due to renal cancer at a median follow-up of 21.7 (SD 10.6, min 6–42) months, all in solid category. Independent review of serial radiological imaging of these seven cases showed two patients had subtle metastatic disease at the initial presentation, and 5 of the 7 did not adhere to recommended imaging regime. 33 (33/158; 20.8%) died due to other causes including non-renal cancers (14/158; 8.8%). Multivariate analyses showed that lower eGFR at baseline, co-morbidities and tumour location were independently associated with growth in size. Conclusions A higher cancer-specific mortality was seen in the present study compared to the reported literature. Independent critical review of imaging of cases with poor outcome underscored the importance of adherence to a robust protocol including follow up. Comorbid conditions had a significant impact on growth and overall survival of patients with SRMs.

AB - Objective To determine outcomes of small renal masses (≤4 cm) on active surveillance and explore factors which can influence their growth. Patients and methods Two hundred twenty six patients between January 2007 and December 2014 were analysed using cross-linked methodology of healthcare data and independent review. Cancer specific and non-specific survival were the primary outcomes. Growth kinetics, factors influencing growth and need for interventions were secondary outcomes. Results 101 (64.4%) solid and 4 (5.9%) cystic SRMs showed growth. 43 (19.02%) of SRMs required treatment interventions. Seven patients (7/158; 4.4%) died due to renal cancer at a median follow-up of 21.7 (SD 10.6, min 6–42) months, all in solid category. Independent review of serial radiological imaging of these seven cases showed two patients had subtle metastatic disease at the initial presentation, and 5 of the 7 did not adhere to recommended imaging regime. 33 (33/158; 20.8%) died due to other causes including non-renal cancers (14/158; 8.8%). Multivariate analyses showed that lower eGFR at baseline, co-morbidities and tumour location were independently associated with growth in size. Conclusions A higher cancer-specific mortality was seen in the present study compared to the reported literature. Independent critical review of imaging of cases with poor outcome underscored the importance of adherence to a robust protocol including follow up. Comorbid conditions had a significant impact on growth and overall survival of patients with SRMs.

KW - Active surveillance

KW - Co-morbidities

KW - Growth patterns

KW - Outcomes

KW - Small renal masses

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DO - 10.1016/j.ejso.2017.03.006

M3 - Article

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SP - 1589

EP - 1597

JO - Clinical Oncology

JF - Clinical Oncology

SN - 0748-7983

IS - 8

ER -