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Current patterns of presentation and treatment of renal masses: a clinical research office of the endourological society prospective study.

Abstract：

PURPOSE:To assess epidemiologic characteristics, clinical and pathologic patterns of presentation, and treatment strategies in a contemporary population with renal masses (RMs). METHODS:The Clinical Research Office of the Endourological Society collected prospective epidemiologic, clinical, and pathologic data on consecutive patients with RMs who were treated during a 1-year period in 98 centers worldwide. Preoperative assessment and treatment were performed according to local clinical practice guidelines. RESULTS:From January 2010 to February 2012, 4288 patients (4355 cases, 4815 tumors) were treated for a RM. The mean age of the cohort was 61.5 years, and the ratio male:female 1.8:1. Caucasians represented 75% of the population, and the median body mass index was 27. The cohort exhibited a high rate of comorbidity (65.6%), including a 48.5% rate of hypertension; one-third of patients had a combination of two or more comorbidities. One-third of patients (36%) had risk factors for renal-cell carcinoma (RCC), of which smoking and obesity were the most common. Diagnosis was incidental in 67% of cases, and 22.2% of cases had chronic kidney disease stage ≥III at presentation. Median radiologic size was 44 mm (range 2-300 mm) and 68% were cT1. Radical nephrectomy and nephron-sparing surgery (NSS) including ablation were performed in 52% and 46% of cases, respectively, while 3.6% of cases were actively surveyed. Median pathologic size was 43 mm (range 2-300 mm) and 63% of the RCCs were pT1. CONCLUSIONS:Current patterns of presentation of RMs are consistent with the decreasing trends in age and clinical or pathologic size and increasing incidental diagnosis. Patients exhibit a considerable basal comorbidity and presence of risk factors for RCC. Half of the cases are treated by a nephron-sparing modality with an increase in the penetration of NSS techniques in the contemporary urologic practice.

journal_name

J Endourol

journal_title

Journal of endourology

authors

Laguna MP,Algaba F,Cadeddu J,Clayman R,Gill I,Gueglio G,Hohenfellner M,Joyce A,Landman J,Lee B,van Poppel H,Clinical Research Office of the Endourological Society Renal Mass Study.

doi

10.1089/end.2013.0724

subject

Has Abstract

pub_date

2014-07-01 00:00:00

pages

861-70

issue

eissn

0892-7790

issn

1557-900X

journal_volume

pub_type

杂志文章,多中心研究

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Current patterns of presentation and treatment of renal masses: a clinical research office of the endourological society prospective study.