Predictors of growth kinetics and outcomes in small renal masses (SRM ≤4 cm in size): Tayside Active Surveillance Cohort (TASC) Study

Abstract

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.

Outcomes of synchronous and metachronous bilateral small renal masses (< 4 cm): a population-based cohort study

“…Observations in this study suggest that despite bilateralism, SRMs behaviour in a particular size range (<4 cm) remains the same. In our experience, most of metastases develop within first two years of follow-up and some of these may be missed subtle disease in distant organs at the time of first detection [20]. In contrast to hereditary disease, where growth is fast and multiple interventions are anticipated, non-hereditary disease with bilateral synchronous renal cell carcinoma can be managed by a single nephron-sparing surgery with acceptable morbidity.…”

“…The word file contained unique identifier number (CHI), demographic details, type of presentation, stage, histology, grade, radiological finding and final consensus decision of the multidisciplinary team. Our previous reports have validated the data quality of this process including record linkage methodology through a common identifier (CHI number) using a deterministic record linkage strategy [13][14][15]. Figure 1 summarises the study cohort, flow and systems used for record-linkage.…”

“…Demographic characteristics, number and type of interventions, complications and follow-up outcomes were analysed. A primary interest of this study was to assess the growth rate of those masses on active surveillance as we have recently published on a larger cohort focusing on active surveillance [15].…”

“…A group of patients diagnosed with bilateral small renal masses were compared with those diagnosed with unilateral disease using propensity score matching for variables known to influence growth such as size, location etc. Progression was defined as any increase in size on followup or change in tumour characteristic on follow-up imaging as described previously [13,15].…”

Abbreviated MRI Protocols for the Abdomen

“…The detection of small renal masses (≤4 cm) has increased in recent decades (55). The findings from prospective and retrospective studies have shown very low progression rates for these tumors (<2%), even when they are malignant.…”